Low melatonin and dyspepsia in menopause

reference

Chojnacki C, Mędrek-Socha M, Konrad P, Chojnacki J, Błońska. The value of melatonin supplementation in postmenopausal women with Helicobacter pylori -associated dyspepsia. BMC women's health . 2020; 20 (1): 262.

Study goal

This study aims to assess the cause of chronic dyspepsia in patients with low melatonin levels (ie women after menopause) and their connection Helicobacter pylori infection.

draft

randomized, placebo-controlled study

participant

All 152 participants were postmenopausal women between the ages of 49 and 64. The exclusion criteria included those who received hormone replacement therapy or had a prehistory with inflammatory, metabolic, allergic or mental illnesses.

The participants were divided into 3 groups:

• Group 1: No Helicobacter pylori or dyspepsies symptoms (n = 30)
• Group 2: Asymptomatic Helicobacter pylori infection (n = 60)
• Group 3: Symptomatic Helicobacter pylori infection (n = 64)
  • Group 3a was the placebo group
  • Group 3b was the melatonin treatment group

Intervention

only group 3 received the intervention. Group 3b received 1 mg melatonin in the morning and 3 mg melatonin before going to bed, while group 3a received a suitable placebo that was taken at the same times of the day.

study parameters evaluated

The researchers at the beginning carried out a urea at the endoscopy of the upper gastrointestinal tract (GI) and a histological examination to confirm this Helicobacter-pylori infection. They repeated the urea breath test again after 3 and 6 months.

You rated dyspepsia symptoms based on the visual analog scale.

The researchers rated other parameters at the beginning and again in the 1, 3 and 6-month follow-ups. These included a complete blood count (CBC), C-reactive protein, glycosylated hemoglobin, bilirubin, liver enzymes, pancreatic enzymes, urea, creatinine, lipid-assay, 17-beta-ecstradiol, follicle-stimulating hormone, serumfood and urine-6- Sulfateoxymelatonin.

therapeutic approach

All participants in the symptomatic Helicobacter pylori infection group (group 3) received an antibiotic protocol: daily pantoprazole (2 x 40 mg), amoxicillin (2 x 1,000 mg) and levofloxacin (2 x 500 mg) for 14 days.

Then group 3 was divided into 2 same groups: Group 3a received placebo, 2 tablets a day; Group 3b received melatonin for 6 months, 1 mg every morning and 3 mg before going to bed.

The researchers instructed all participants to stick to 1,600 calories every day during the 6-month study period.

important knowledge

The first observations showed that women in group 3 (symptomatic helicobacter pylori infection) had lower melatonin level in serum (5.72 ± 1.42 pg/ml; p <0.001) compared to the arms of group 1 (12.5 ± 2.72 pg/ml) and group 2 (10.5 ± 3.73 pg/ml).

At the beginning of the study, the 6-sulfateox symelatonin level in 24-hour urine in women with asymptomatic ( p <0.001) and symptomatic ( p <0.001) Helicobacter-Pylori Infection.

There was no statistically significant difference between the 3 groups regarding 17 Betaestradiol ( p 0.05), follicle-stimulating hormone ( p 0.05) or other laboratory parameters.

Both groups received 3a (placebo) and 3b (melatonin) by protocol. Helicobacter pylori Eradication treatments for 2 weeks. Exmination of Helicobacter-pylori tended in group 3b (84.3 %) higher than in group 3a (75 %) ( p 0.5).

After 6 months, the symptoms of dyspepsia disappeared in group 3b in group 3b compared to 43.7 % of patients in group 3a ( p <0.001).

practice implications

melatonin is synthesized from L-tryptophan in the pineal gland in a 4-stage process, which contains serotonin as an intermediary. Melatonin is most frequently used to treat insomnia due to anomalies of the circadian rhythm or jet lag. Also found to be an endogenous antioxidant, ^{1 melatonin supports almost every system in the body, including immune-, 2 eye, 3 and gastrointestinal functions. 4.5 as already reported, melatonin production takes natural ways with increasing age after adulthood from. 6 In the current study, Chojnacki et al.}

hormone changes are part of the natural menopause process, but this study implies that a low melatonin level can be the difference between symptomatic and asymptomatic Helicobacter-pylori infection.

This is not the first study on melatonin and dyspepsia. Various studies have already been carried out in terms of melatonin on the gastrointestinal tract. Chojnacki et al. suggest that dyspepsia symptoms can be caused locally in the gastric mucosa by reduced production of melatonin. This is made by publication in the magazine for pineal gland research which found a connection between gastric luminal melatonin level and bicarbonate secretion in the gastrointestinal tract. Nervous system 11 and stimulation of the Migrating Motor Complex (MMP) 12 systems that are closely involved in digestion.

This study complements the evidence of the connection between intestinal health and melatonin mirrors.

orally administered melatonin is well tolerated. In insomnia, melatonin is typically taken up in doses between 0.1 and 6 mg 1 to 3 hours before going to bed. After about 40 minutes, the melatonin levels in the serum reach their high with an elimination half -time of 54 minutes with oral intake. ^{13 Therefore, the researchers used more frequent doses to treat dyspepsy in this study. The dosage in this study was 1 mg in the morning and 3 mg before going to bed, and only 4 out of 32 women reported fatigue. However, it has been shown that the intake causes drowsiness during the day, 14 Therefore should be caution when dosing outside of bedtime.}