Melatonin and painful gynecomastia

ALS is a devastating degenerative disease affecting central and peripheral motor neurons, with a 50% survival probability at approximately 3 years. This bleak prognostic outlook, the absence of drugs that dramatically alter the natural history, and evidence that oxidative mechanisms with excessive formation of free radicals are involved in ALS pathogenesis have led patients to search for over-the-counter preparations with presumed antioxidant functions. Rodent studies have indicated that pharmacologic doses of exogenous melatonin can protect neurons against oxidative damage.1,2 No adequately conducted human efficacy studies are available. Nevertheless, many patients try melatonin to halt the progression of several neurologic degenerative diseases in which oxidative mechanisms have been implicated.1 No serious side effects have been reported with the acute or long-term ingestion of melatonin.3,4 Numerous synthetic melatonin preparations are available at health food stores or pharmacies in several countries. We report an ALS patient who developed painful gynecomastia after prolonged ingestion of pharmacologic doses of melatonin. A 56-year-old man complained of painful, asymmetric …