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Theres also a black-box warning for thyroid C-cell tumors from rodent studies clinical significance in humans remains under investigation ( MedlinePlus, 2026 )

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J Pineal Res 34:4052 Jaworek J, Nawrot K, Konturek SJ, Leja-Szpak A, Thor P, Pawlik WW (2004) Melatonin and its precursor, L-tryptophan: influence on pancreatic amylase secretion in vivo and in vitro

However, this can vary depending on the severity of the RA flare-up, and patients should always consult their rheumatologist before starting a new regimen