Melatonin and Cannabis Products Often Mislabeled  

By Pat Anson, PNN Editor

If you use cannabis for pain relief or take melatonin to help you sleep at night, you may want to check the label and ask the manufacturer just how accurate the list of ingredients is.  Or think twice before buying it.

Two more studies are raising doubts about the accuracy of label claims on cannabis products and melatonin supplements, which are often marketed with unsupported claims about their health benefits.

In the first study, published this week in JAMA, researchers analyzed 25 melatonin gummy products, including 5 gummies that also contained cannabidiol (CBD). Melatonin is a natural hormone produced by the brain at night to help induce sleep. Supplements containing synthetic melatonin and/or CBD are often marketed as products that improve sleep, reduce anxiety, and promote relaxation.

Researchers found that only 3 of the 25 gummies contained enough melatonin to be within 10% of the labeled amount – with one product containing 347% more melatonin than what was listed, a potentially dangerous amount. Another gummy contained no melatonin at all, just CBD.

“The great majority of melatonin gummy products were inaccurately labeled, with most products exceeding the declared amount of melatonin and CBD,” wrote lead author Pieter Cohen, MD, an associate professor at Harvard Medical School and an internist at Cambridge Health Alliance. “Given these findings, clinicians should advise parents that pediatric use of melatonin gummies may result in ingestion of unpredictable quantities of melatonin and CBD.”

Pediatric use is concerning because calls to U.S. Poison Control Centers about children ingesting melatonin have increased five-fold over the past decade, resulting in nearly 28,000 emergency room visits, over 4,000 hospitalizations and two deaths.

Researchers say it takes just 0.1 mg to 0.3 mg of melatonin to increase plasma levels beyond the normal nighttime range in young adults. The amount of melatonin found in the gummies was much higher, including one product containing 13.1 mg of melatonin.

“Consuming melatonin gummies as directed could expose children to between 40 and 130 times higher quantities of melatonin,” they said. “With respect to CBD, the drug is FDA approved to treat refractory seizures caused by 3 rare genetic disorders, but the FDA has not approved the use of CBD for any indication in healthy children.”

The JAMA report is believed to be the first U.S. study to quantify the amount of melatonin in over-the-counter supplements. A 2017 Canadian analysis of melatonin products had similar findings, with the actual dose of melatonin ranging from 17% to 478% of the amount listed on the label. Neither the U.S. or Canadian studies identified the melatonin brands that were tested.

Too Little THC

It wasn’t too much, but too little tetrahydrocannabinol (THC) that University of Northern Colorado researchers found in 23 cannabis flower products purchased at state-licensed dispensaries. The study findings, recently published in the journal PLOS One, show that nearly 70% of the flower samples had THC levels at least 15% lower than what was listed on their labels.

Inaccurate labeling has long been a problem in the cannabis industry. Some growers and merchants resort to “lab shopping” to seek out product testing laboratories that generate the most desirable results – which means inflated levels of THC.  There’s a financial incentive to do so, because cannabis products containing high amounts of THC usually sell at a higher price.

One of the flower samples, purchased at a Denver dispensary and sold under the brand name “OG Kush 2,” had only half the amount of THC listed on its label.  

“Given our results it is urgent that steps are taken to increase label accuracy of Cannabis being sold to the public. The lack of accurate reporting of THC potency can have impacts on medical patients controlling dosage, recreational consumers expecting an effect aligned with price, and trust in the industry as a whole,” researchers said.

“Although we have no power to change the current system, we hope highlighting this issue and educating consumers will affect the change needed to remedy inflated potency of flower products. Addressing this discrepancy will require both changes to the regulatory system and consumer awareness that reported THC potencies are frequently inflated.”

Although 38 states and Washington DC have legalized medical or recreational cannabis, there is little consistency in labeling, regulating or testing cannabis. The researchers called for more regulatory oversight of cannabis and standardized testing protocols.

Can Melatonin Put Your Chronic Pain to Sleep?

By A. Rahman Ford, PNN Columnist

Melatonin is popularly known as the sleep hormone. Less known is its potential to alleviate chronic pain and inflammation.

Melatonin is a natural hormone produced by the pineal gland in the brain. During the day the pineal gland is inactive, but at night it begins to produce melatonin and helps us sleep.

As a supplement, melatonin is widely promoted for its efficacy as a sleep aid. However, its role in reducing inflammation – a major contributor to chronic pain – may be much more important. Many chronic pain conditions are a result of underlying inflammation.

In a recent Nature article, melatonin was called a “master regulator” of inflammation. Several studies have shown that melatonin can regulate activation of the immune system, reducing chronic and acute inflammation.

Research shows that melatonin supplements can modulate inflammation by acting as powerful antioxidants and free radical scavengers. Uncontrolled free radicals in the body can lead to oxidative stress, which can cause inflammation and culminate in diseases that cause chronic pain.

There is a large body of evidence that melatonin is a potent antioxidant, even more potent than vitamins C and E.  It’s been successfully used to treat fibromyalgia and irritable bowel syndrome, diseases associated with high levels of oxidative stress.

Melatonin is also a strong antimicrobial, and emerging research shows that some chronic inflammatory conditions may be caused by infections. One study found melatonin effective in treating certain drug-resistant bacteria such as Staphylococcus aureus, Pseudomonas aeruginosa and Acinetobacter baumannii. Similar results were found when testing ten different pathogens, including Escheria coli and Salmonella typhinurium, with melatonin.

Melatonin and Chronic Pain

A therapeutic role for melatonin in the treatment of painful autoimmune conditions has been theorized.  A 2013 study noted that melatonin plays a role in the pathogenesis of conditions such as multiple sclerosis and systemic lupus. In animal models of these diseases, melatonin supplements were found to have protective effects. A 2019 review concurred, concluding that melatonin can serve as a new therapeutic target in treating autoimmune diseases.

A review of the scientific literature on chronic pain syndromes found evidence of melatonin’s efficacy as an analgesic in several conditions including fibromyalgia, irritable bowel syndrome and chronic back pain. Studies also showed melatonin’s effectiveness in treating cluster headaches ad tension headaches.

A small clinical trial of 63 females with fibromyalgia found that melatonin, alone or in combination with the antidepressant amitriptyline, significantly reduced pain when compared to amitriptyline use alone. The authors concluded that the melatonin treatment had a direct effect on the regulation of pain.

There has been some evidence that melatonin supplements can help reduce lower back pain. In a 2015 study, researchers found a significant reduction in pain intensity during movement and at rest in patients with back pain.

Melatonin has also been successful in treating migraines. In an open-labeled clinical trial of 34 patients suffering from migraine, 30 mg of melatonin given 30 minutes before bedtime was found to reduce headache intensity as well as frequency and duration, with significant clinical improvement after one month.

Although the scientific evidence is only slowly emerging, melatonin is a widely-available, inexpensive and safe supplement that may aid you in your fight against chronic pain.

A. Rahman Ford, PhD, is a lawyer and research professional. He is a graduate of Rutgers University and the Howard University School of Law, where he served as Editor-in-Chief of the Howard Law Journal.

Rahman lives with chronic inflammation in his digestive tract and is unable to eat solid food.

The information in this column is for informational purposes only and represent the author’s opinions alone. It does not inherently express or reflect the views, opinions and/or positions of Pain News Network.