In this week’s Q&A, I focused on melatonin for longevity, omega-3 ratios, and why protein quality matters more than most people realize. We covered excellent questions from premium subscribers and practice members.
As always, this is for general education. It’s not medical advice. I’m not practicing medicine via Q&A.
Here’s what we covered…
Low-Dose Melatonin for Anti-Aging
How should you approach melatonin supplementation if you’re already sleeping well? Great question.
As we age, melatonin production drops dramatically. My approach is whenever someone’s sleep starts to deteriorate, we eventually add melatonin at a low dose. What’s the optimal dose? No one has really worked this out, but Russell Reiter, the great of melatonin research, settled on about eight milligrams a night if I recall correctly from his book. He took that well into his advanced years. I believe Russell is still alive and he’s got to be in his nineties now. He’s doing something right.
I like a dose somewhere in the range of five, ten, fifteen as a rule for longevity and anti-aging. We don’t have robust evidence for that, but the best evidence we have is very strong and very encouraging.
I will go to higher doses if I’m trying to optimize someone’s sleep or get them to sleep. That’s where our high-dose melatonin protocol comes in, which is available to practice members or to members of the Substack behind the paywall.
For most people, we use the lowest effective dose to get someone to sleep. That can be half a milligram, three milligrams. What I see people doing is they go to those low doses and then they don’t know they can go any higher and they think it doesn’t work. Trust me, it works. High doses of melatonin are like a wrecking ball in a good way.
Most of my patients are not on melatonin for the record. There’s such a significant burden of supplements with what we do already that I try to keep it simple. I’m trying to keep my protocols for people between five and ten different things.
Einstein said, make it as simple as possible and no simpler.
Da Vinci said, simplicity is the ultimate sophistication.
I really try to live that in my practice.
Melatonin as Antioxidant vs Sleep Hormone
When is melatonin best viewed as an antioxidant versus a sleep hormone? Another great question.
I don’t tend to use melatonin as an antioxidant. The reason for that is I’ve got vitamin C and it’s much easier for me to administer because the powder is very quick, very strong. Vitamin C will also naturally regenerate melatonin. Melatonin will not regenerate vitamin C.
That’s one reason why I love the high-dose vitamin C protocol. We have vitamin C in stock at the store. It’s one of my favorite supplements. Patients come back raving about it all the time. I’ve had multiple testimonials about it in the last few weeks.
My point is I don’t really use melatonin as a supplement for antioxidant purposes. I always use it as a sleep hormone. Now the people who need it most also need an antioxidant. So I’ll use the vitamin C and the melatonin protocol together in those cases.
Choosing Quality Herb Suppliers
What makes a high-quality herb supplier trustworthy? What should people look for?
I like Mountain Rose Herbs in particular. What do I like about them, and in general what’s an indicator of a high-quality brand? Practitioners use them.
I cannot tell you how many herbalists I know whose go-to for any sourcing is Mountain Rose Herbs. If you really want to know what works in anything, ask the people who do it every day and who don’t get paid if it doesn’t work.
Part of why I’m so passionate about what I do, is patients come back and they’re so happy, they’re so grateful, they’re so positive, they’re so encouraged by the big shifts they see in how they feel, how they function, their overall well-being.
Herbalists, if their herbs don’t work or if their herbs poison people, they are not going to be able to make rent. They have a strong incentive for finding good quality product. Having tried their product, I’ve just always been impressed.
Why Lean Meats Support Repair
Why lean meats? What’s unique about them for supporting repair while minimizing inflammation?
When I say lean meats, I’m talking about muscle meat. I’m not talking about organ meats or shellfish. I’m talking about fish, chicken, poultry, turkey, and beef.
Muscle meat is predominantly protein with some fat. What we find is that when people are very sick and frail, they don’t have the resilience to accommodate dramatic shifts in micronutrients.
Shellfish, for example, have really high concentrations of things like copper and manganese. In people who do not have a firm base and resiliency and a good mineral balance, those things can really derail them.
That’s why if you ask a very sick patient, very elderly, frail patient, would you like to have a dozen oysters? Most of them will say, no, I don’t think I can handle that. That’s their body saying no.
Other things in this category would be many of the organ meats. The organ meats, depending upon the animal, tend to accumulate certain nutrients which can become present in toxic levels.
Beef liver can cause massive swings in copper levels and vitamin A levels. That’s not something that someone who’s sick and frail can accommodate. You’ll find that these people wind up in very high copper levels, very low zinc levels. They’ll be in these extremes of physiology where nutrients have been very imbalanced for long periods of time.
The Omega-3 to Omega-6 Ratio
How important is the omega-3 to omega-6 ratio? How should people think about it practically?
I think it is very important. That’s why I still take fish oil. To this day, I take two to three grams a day of fish oil. We have some on our online store. One of the reasons I’m a big enthusiast of omega-3 supplementation is the cognitive enhancement that we see in studies of people who take fish oil and omega-3s in particular.
I want my brain to work optimally for as long as possible. Pretty much everyone I’ve seen in the dementia space who has any real clinical chops and experience is using omega-3s in their practice.
How do we get to a healthy omega-3 to omega-6 ratio? Formerly, it seems to have been one to one in our diets a long time ago. Now it’s more like one to twenty. We need to shoot for ideally one to four.
This is one reason why we’ll test the omega quant in the practice. I shoot for one to four omega-3s to omega-6s based on that test.
I strongly encourage people to look at their diet in an app like Chronometer. What you will find is that you can predict your fatty acid levels in your blood pretty reliably from Chronometer. You’ll also find that there’s a fair amount of variability.
I was looking at some the other day for a gentleman who had it done in multiple labs over multiple months and there was a swing of 0.5 or more percentage points in his omega-3 level, which can have huge impacts on your omega-3 to omega-6 ratio. So don’t think that the lab testing is the be-all end-all.
My goal in a diet is two to three grams of omega-3s every day. That’s from a combination of all sources. This is the other reason why I don’t just blanket say everyone needs fish oil. You will actually find some people tend to over-supplement on fish oil.
The sweet spot is if you get two to three grams of omega-3s a day, predominantly from fish, you will tend to have an optimal omega-3 to omega-6 ratio.
I almost always find that somebody who’s got a high omega-6 level, their favorite snack is pistachios, cashews, almonds, and they’re eating a lot of them. What nuts and seeds do you eat? Do you eat out a lot? There’s restaurant oils that are high in omega-6s.
Nothing wrong with these things, but coming back to the food pyramid analogy, they belong in the middle. That means you can’t make them your base, and that means you’ve got to have some moderation there.
Final Thoughts
Thank you, as always, for your questions and your support. Your memberships and supplement purchases make this work possible and allow me to keep sharing what actually helps rather than adding to the noise in the wellness world.
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Until next time, be well,
Dr. Stillman
Executive Summary
Melatonin dosing for longevity ranges from 5-15 mg nightly for most people.
Russell Reiter took about 8 mg nightly well into his nineties.
Vitamin C is preferred over melatonin for antioxidant purposes.
Mountain Rose Herbs is trusted because practitioners rely on them daily.
Lean muscle meats minimize inflammation better than organ meats or shellfish for sick patients.
Optimal omega-3 to omega-6 ratio is approximately 1 to 4.
Target 2-3 grams of omega-3s daily from all sources.
Chronometer app helps predict fatty acid levels reliably.
High omega-6 levels often trace to nuts, seeds, and restaurant oils.
Shellfish and organ meats can cause mineral imbalances in compromised patients.
