Does anyone take Melatonin while taking Tamoxifen?

I've been taking both 20 mg of Tamoxifen and 20 mg of Melatonin for about 7 months.  I went to a naturopath that specializes in breast cancer and she prescribed the melatonin to help prevent a recurrence.  I checked with my oncologist and she was fine with it.  (The other thing she prescribed was Curcumin and my oncologist Ok'd that too.)

I've been on tamoxifen for 14 months and just recently started taking 3mg melatonin before bed to help me sleep. I never have trouble falling asleep, but since being on tamoxifen I often wake up in the middle of the night and then can't fall back asleep. My doctor said that each of us has a "sweet spot" regarding melatonin, and if the 3mg didn't work, then to step down to a lower dose (I think it also comes in 1.5 mg and 0.5 mg). So if you're taking it for sleep issues, more is not necessarily better. The 3mg seems to be working for me. Now if I wake up during the night, I can go to sleep again and so I feel rested in the morning. But more often than not I sleep through the night, which is even better.

I'm going to double check with my naturopath on whether melatonin or curcumin interferes with the effectiveness of tamoxifen.  She specializes in breast cancer so I trust her recommendations and my oncologist is the director of the breast cancer center I go to so I was happy when she OK'd me taking all of these things together.  This thread and another one on tumeric and tamoxifen are the first discussions I've heard that it could be a problem. Thanks for everyone's comments.  I'll post again once I check it out.

I saw a Naturopathic Oncologist (I guess they are rare) at the Cancer Treatment Center of America when I was diagnosed almost 3 years ago.  He wasn't big on recommending a ton of supplements..thought you should try to just eat a good healthy diet and exercise.  But two of the few supplements that he DID recommend were melatonin and curcumin.  I take 10 to 20 mgs of melatonin most nights.

I saw my naturopath on Friday and asked her whether she knew of any negative interactions between tamoxifen and melatonin or between tamoxifen and curcumin.  She was not aware of any but said she would do some research and get back to me.  She just sent me a number of links to information which I have not fully read yet but I thought I'd pass some of them on.

The first is a link to a blog written by Dr. Brian Lawenda, an intergrative oncologist, about his attendance at the 2nd Annual OncANP Conference in Phoenix in February this year (which my naturopath also attended) where he summarizes a presentation on melatonin and cancer. (http://www.integrativeoncology-essentials.com/2013/02/just-got-back-from-a-great-naturopathic-cancer-conference-oncanp-update-on-melatonin-and-cancer-treatment/)   At the bottom of the blog are some excellent links to more information about melatonin and cancer, e.g. the American Cancer Society's position on it.  The "Melatonin, Chronobiology and Cancer" link contains comments by Dr. Paolo Lissoni (on pages 22-25) who seems to be the main long-term researcher on melatonin and cancer.  He did a study in the mid 1990s on fourteen Stage 4 breast cancer patients whose cancer progressed while on tamoxifen.  When he added melatonin to their treatment, most improved.  Admittedly, this is a very small study, but it is the only one I'm aware of about tamoxifen and melatonin together.  The conclusion was the combination was a benefit to patients.  Here's a link to the study:  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2033724/?page=1.  My naturopath is not aware of any studies that show a negative interaction between tamoxifen and melatonin.  Here's a link to an article she sent me about things melatonin interacts with:  http://naturalmedicinejournal.net/pdf/nmj_nov09int.pdf.  The Life Extension article from 2004 talks about the Cancer Treatment Centers of America doing an expanded study of Dr. Lissoni's positive findings about using melatonin on lung cancer patients.  My naturopath said she'd see if anything further came of that study.  I couldn't find anything.

As far as the interaction between tamoxifen and curcumin, she said there are conflicting studies on it but her conclusion was that it was OK for me to take it and she forwarded this blog post by Dr. Keith Block about the issue:  http://lifeovercancerblog.typepad.com/life-over-cancer-blog/2013/06/curcumin-tamoxifen.html.

Well that's it for now.  I'll be looking over the other information she sent me this week to see if there's anything else to pass on.  The other information she sent is mainly power point slide presentations from conferences she attended that seem confusing and are very long.  The shortest one is 60 pages.

Hope this is helpful.

yes I will just start on tamoxifen and I will take 10 mg melatonin with it. I started taking melatonin when I got diagnosed and doctors were ok with taking it through chemo etc. read articles that it acts well against cancer, especially when taken with tamoxifen

Just a short update on my endoxifen results after stopping curcumin. They are back to the same level from before starting supplementing with curcumin. Doubled since fall, after giving up curcumin. Dr was very happy with the results but also very suprised that it made such a huge difference. He is running a study on drugs and supplements interactions, (mostly drugs), and a lot of his work focuses on tamoxifen. Curcumin was the only new thing I added after 4 months from starting tamoxifen and over the next 2 months my levels dropped from 28 to below 14. Three months after stopping this supplement, active endoxifen in my blood increased to 30.

The brand I took is: BELL. CURCUMIN 2000X #67, 550mg (ingredients: 300mg of turmeric extract 25:1, cayenne pepper 100mg, Hawthorne berries 100mg, vit E 90UI). I only took 1 capsule daily, usually in the morning, while tamoxifen always after 9-10pm.

Just to make it clear, I didn't see any naturopath for advice on how to supplement, so it is possible that I was taking it incorrectly, on my own. I basically don't take a lot of stuff, just basic calcium with magnesium and vit D, (about 600mg daily), vit C 500, additional 1000UI VIT D, vit B6 50mg and high quality fish oil (1 capsule).

We don't know if this specific brand reduced tamoxifen absorption and metabolism in my body, but just in case - no more curcumin for me for as long as I'm on tamoxifen. It could have a totally different effect on another person, maybe if combined with something else, who knows?

snorkler, thank you for the sharing your experience with melatonine and sleeping hygiene. I will try to avoid any electronics before bed time and see if that helps. I've been using my ipad a lot to read books in bed, sometimes hoping to "read" myself to sleep, often without any results. 

As for calcium - there is no interaction with tamoxifen per say, only a possibility that once calcium swallowed, it turns into bulky, sticky substance in the gut, which can coat other pills if taken at the same time, therefore reduce their absorption. (At least this is how I understood what my dr was saying). The best way is to take tamoxifen by itself, at bed time. I take it between 9-10 pm with just a few sips of water.  I usually take everything else with breakfast and/or lunch. (And that was the case with curcumin as well, thought still got an adverse reaction 😒).

SophiaMarie, it is frustrating. I took turmeric based on everything I read about its wonderful properties. There are some studies in vitro saying that it can even enhance tamoxifen efficacy. You can imagine how disappointed I was with the results. I'm almost afraid to think what could have happen if I didn't repeat that blood test and continued the supplement... I wished there was more studies and patient education on any possible interactions with most common supplements. 

I would like to try melatonin, but since I take tamoxifen at night, I don't want to add anything to it. And  I'm assuming that melatonin should be taken around bedtime, right?

Melatonin also acts as a selective estrogen enzyme modulator (SEEM), reducing the activity of aromatase in cells, the enzyme responsible for conversion of androgenic precursors to estrogens.

As I understand it, the only issue with melatonin may be that long term use for some people may lead their brain to become less sensitive, and/or supplementation may lead to the body making less of its own, which could be a problem when the usage is for sleep issues. However, basically there is not a lot of research on longer term use- but see here for an example https://www.ncbi.nlm.nih.gov/pubmed/23432361. Short term, helpful, longer term, not helpful!

With things like curcumin, I think there is a lot to be said to "traditional use" eg having it regularly in food, maybe in tea with milk and ginger (yum). But these substances are still pretty challenging to metabolise (the liver still has to do something with them so they can be safely excreted), so taking as a supplement, especially with other concentrated supplements AND medications, that's quite a load on the whole digestive system.

Swimjames, that article is by the naturopath who has me on both melatonin and curcumin She's very smart and empirically informed.