Melatonin and Heart Failure: It’s Not the Hormone — It’s the State of the Body Using It

Healing_ Passion
2 days ago
3 min read

Last week’s American Heart Association meeting made global headlines:

“Long-term use of melatonin supplements to support sleep may have negative health effects.”

At first glance, that sounds alarming. A natural sleep aid—one our own brain makes—suddenly accused of harming the heart? Let’s look more closely.

What the Study Actually Found

Researchers analyzed five years of electronic health records from over 130,000 adults diagnosed with insomnia.

Those who had documented melatonin prescriptions for at least a year were compared with equally matched insomnia patients who never used melatonin.

After statistical matching for age, sex, comorbidities, and medications, the study reported that melatonin users had:

~89 % higher hazard of being diagnosed with heart failure,
~3.4-fold higher hazard of hospitalization for heart failure, and
~2-fold higher hazard of dying from any cause over five years.

Sounds scary—but here’s the critical detail the news headlines skipped:

🔹 This was an association study, not a cause-and-effect trial. It simply shows correlation, not proof that melatonin caused any of those outcomes.

Even the researchers and the Heart Association’s own press release admitted this, though the headline didn’t.

Why the Headline Misleads

Observational databases like this one can uncover patterns, but they can’t isolate cause.

People who take melatonin every night are not the same as those who don’t. They usually:

have chronic insomnia,
carry higher stress and inflammatory load,
may struggle with anxiety, depression, or metabolic issues, and
Often experience circadian disruption from shift work, screen exposure, or chronic tension.

These factors are independent risk amplifiers for heart disease and heart failure.

So, melatonin use may simply mark a population already in distress, not create that distress.

A More Plausible Explanation: The ERM Perspective

In the Exposure-Related Malnutrition (ERM) framework, persistent insomnia is not a minor inconvenience—it’s a biological signal of maladaptation.

When life’s demands, stress, or environmental exposures outpace our ability to recover:

The body enters a high-alert mode, dominated by stress hormones and sympathetic drive.
Sleep becomes shallow or fragmented because energy is being diverted toward vigilance, not restoration.
Over time, the failure to “switch off” at night drains cellular reserves, impairs repair signaling, and leaves the cardiovascular system operating under constant strain.

This is the bioenergetic cost of resilience—living in survival mode without enough resources for renewal.

Melatonin users are often those whose bodies can no longer maintain a healthy rhythm on their own.

Their supplement use is an indicator of chronic circadian stress, not the cause of heart failure.

In short:

It’s not the melatonin—it’s the maladaptation.

Melatonin: A Natural Hormone, Not a Toxin

Melatonin is made by our pineal gland nightly.

At usual doses (0.3–3 mg), supplements produce hormone levels similar to natural nighttime peaks.

Dozens of clinical trials show it to be remarkably safe in the short and medium term.

Its main role is to signal darkness and recovery, not to sedate or suppress the heart.

There is no known biological mechanism by which physiologic melatonin causes cardiac injury.

What does harm the heart is chronic circadian disruption, sympathetic overdrive, and metabolic exhaustion—the very conditions that drive people to seek melatonin in the first place.

What We Should Really Learn from This Study

Don’t fear melatonin at physiologic doses—but don’t rely on it as a permanent crutch either.
If you need it nightly for months or years, your body is telling you something deeper: you’re living in a state of unresolved stress and energy debt.
The priority is to restore natural rhythm—through light exposure, meal timing, movement, stress recovery, and nutrient sufficiency—so your body produces its own melatonin again.

The Bigger Picture

The takeaway from the AHA abstract is not that melatonin is dangerous, but that sleep disturbance is a clinical warning sign of systemic maladaptation.

When the body’s repair cycle breaks, heart and metabolic disease follow.

The supplement is simply a witness at the scene, not the culprit.