Q. I take Diltiazem for tachycardia. Can I also take Melatonin for sleep problems?

Answered by
Dr. Artur Holubka
and medically reviewed by Dr. Sneha Kannan
This is a premium question & answer published on Oct 03, 2020

I am 67. I take 120 mg Diltiazem twice daily. It was originally given to me because undiagnosed sleep apnea had caused "borderline hypertrophy of the heart" I now also take it because I have a tachycardia once or twice a year. It was not given to me for high blood pressure. When a doctor takes my blood pressure, sometimes it is normal, sometimes it is up to say 140/90, and very rarely it may read just slightly higher. I have been a very light sleeper for a long time. I have just heard that older people produce less melatonin. I checked online and found that there is some possibility of drug interaction between diltiazem and melatonin, but I don't know if it's serious. How concerned should an average male in my situation be about starting to take 5 mg of melatonin bed time? Currently I am on clonapin, prilosec, testosterone, and simvastatin.

# Hello!

First, I have to understand why you are taking tetsosterone.
Diltiazem is not in those doses that would cause any serious disturbance. Melatonin, on the other hand, can actually interfere with testosterone production. But back again, why do you drink it?
Mlatonin deficiency initiates or aggravates the clinical course of all somatic pathologies, which, in turn, can lead to testosterone deficiency at any age. This completes the vicious circle of pathogenesis of most somatic and age-associated diseases in men. In this regard, it is very important to timely diagnose sleep disorders in men with any pathology, including andrological diseases.

And when it comes to blood pressure, you are not as bad as your age group. Your weight is not so bad either. Although 5-7 kilograms can be dropped.

To help you further, I wrote you what you need to do.

If you liked my consultation, I will be grateful for the feedback and assessment of my work.

Best wishes, Dr. Arthur Holubka
Investigations to be done:

1. Today, a new unique method for accurate laboratory diagnosis of melatonin deficiency has appeared, based on the calculation of the level of its free fraction in saliva (steroid profile in saliva). This method allows you to determine the free fractions of not only melatonin, but also other steroid hormones (free testosterone, cortisol, cortisone, progesterone, dehydroepiandrosterone, androstenedione) and has a high measurement accuracy (free melatonin levels are best measured at night - during the physiological peak of its secretion by the pineal gland)/

2. You also need to conduct a study of the brain, namely the pituitary gland and the pineal gland. On MRI, we will see a pituitary adenoma or calcification of the pineal gland.

3. For a detailed understanding, I recommend that you do a complete blood count and biochemistry.

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