The Therapeutic Potential of Melatonin: A Review of the Science

Samir Malhotra, MD; Girish Sawhney, MD; Promila Pandhi, MD

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Clinical Evaluation of the Patient

No definitive guidelines have been formulated for clinical evaluation of patients with low melatonin levels, in large part because a "melatonin deficiency syndrome" has not yet been defined as an independent entity. The secretion of melatonin is usually detected by analyzing the serum or salivary levels.[151] The salivary levels are considered equivalent to serum levels except in the elderly or in patients with dry mouth.[152] In the first situation, the validity, and in the second situation, the feasibility of salivary melatonin levels are compromised. If the treating physician suspects that melatonin deficiency may be responsible for a patient's symptoms, it is tempting to consider the possibility of exogenous administration of melatonin. However, we must await more substantive clinical evidence before any precise recommendations can be made.

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