doi: 95
Loss of mtGSH disrupts m, promotes MOMP, and activates intrinsic apoptotic signaling, whereas restoration of mtGSH via GSH ester supplementation suppresses apoptosis 38,40
Therefore, metformin could be an effective treatment strategy that may overcome the limitation of PD treatment

Safe Protocol for Medication Users Follow this systematic approach: Pre-Start Checklist [ ] List all current medications (prescription, OTC, supplements) [ ] Research each medication for melatonin interactions [ ] Identify high-risk combinations requiring medical supervision [ ] Schedule pharmacist or doctor consultation if needed [ ] Get explicit approval from prescriber if taking high-risk medications Starting Protocol [ ] Begin with very low dose (0.3mghalf of typical starting dose) [ ] Take 2-3 hours before bed (not right before sleep) [ ] Maintain consistent timing of all medications [ ] Keep detailed journal: medications, melatonin dose, effects, side effects Monitoring Period (First 2 Weeks) [ ] Watch for signs of interaction: Excessive daytime drowsiness Dizziness or lightheadedness (blood pressure) Blood sugar changes (if diabetic) Unusual bruising/bleeding (if on blood thinners) New or worsening side effects [ ] Measure relevant parameters: Blood pressure (if on BP meds)twice daily for 1 week Blood glucose (if diabetic)continue normal monitoring schedule Sleep quality and side effects Long-Term Management [ ] Use lowest effective dose [ ] Maintain consistent schedule [ ] Update interaction assessment when medications change [ ] Annual review with healthcare provider [ ] Periodic pharmacist review (especially if new medications added) Red FlagsStop Melatonin and Contact Doctor If: Unusual bleeding or bruising Significant dizziness or blood pressure changes Unexplained blood sugar swings Severe daytime sedation New or concerning symptoms Medications become less effective 11

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Prioritise bioavailability through liposomal or other advanced delivery technologies