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The Vitamin and Mineral Deficiencies That May Be Causing Your PMS...
Vitamins and minerals are essential to general health but they are used mostly as supplements rather than the main treatment course. This is not the case with premenstrual syndrome where minerals such as calcium and magnesium as well as vitamins such as vitamin B6 can be used solely (or in combination) to manage the condition. Why are these vitamins and minerals effective? Because their deficiencies can cause PMS. This article identifies and discusses the 5 minerals and vitamins that are essential to the management and prevention of PMS.
Women with premenstrual syndrome (PMS) usually turn to alternative medicines and natural products because prescription drugs offer little relief and significant risks of serious adverse effects.
As the medical community agree that standard antidepressants, and other prescription medications used to treat PMS, are less than ideal, more studies are being done to investigate the efficacy of natural supplements for this condition.
In a 2009 review of past studies published in The Canadian Journal of Clinical Pharmacology, the reviewers combed through databases of medical researches to determine which herbs, vitamins and minerals are most helpful for PMS.
Out of the 62 such natural products studied, the reviewers found evidences to support the use of 10 of these.
From their conclusions, the herbs that help with PMS are chasteberry, ginkgo, soy, saffron and St. John’s Wort. In addition, there was strong evidence to support the use of calcium and significant supports for magnesium, vitamin B6 and vitamin E.
Some experts have argued that the symptoms of PMS can be accounted for by nutritional deficiencies.
In their opinions, PMS is the result of calcium and magnesium deficiencies as well as deficiencies of vitamin B6 and E.
So, what are the links between PMS and each of calcium, magnesium, vitamin B6 and vitamin E?
Calcium is an important mineral in the body. It is popularly known for its central role in bone health. However, besides increasing bone mineral density, calcium is also important to muscle contraction and the release of neurotransmitters in the brain.
Low calcium levels can result in calcium deficiency. Although calcium is easily obtained from the diet, calcium deficiency is quite common.
While many associate calcium deficiency with bone diseases such as osteoporosis, it can also be responsible for PMS. In fact, PMS and calcium deficiency share a number of symptoms.
Calcium deficiency in women with PMS may be caused by inability to store calcium, vitamin D deficiency, kidney disease and hypoparathyroidism.
In a study published in the Journal of the American College of Nutrition in 2000, the reviewer summarized the evidence to support the benefits of calcium in the management of PMS. The author provided a number of insights into the relationship between calcium and PMS.
First, the reviewer noted the cyclic fluctuation of calcium levels (as well as vitamin D levels) that coincides with the menstrual cycle.
Studies show that calcium and vitamin D levels were at their lowest during the luteal phase and at the height of PMS symptoms.
Secondly, the review identified that ovarian hormones affect the metabolism of calcium and vitamin D as well as magnesium. This effect of female sex hormones released during the menstrual cycle can reduce the levels of these minerals and vitamin.
For example, estrogen affects calcium levels by influencing the absorption of the mineral across the intestine, its metabolism as well as the activities of parathyroid gland.
Therefore, changes in estrogen before, during and after the menstrual period will also cause changes in calcium levels. In one way, PMS can be clinically described as a state of hypocalcemia. From that perspective, it is expected that both conditions will share symptoms such as depression and anxiety.
This calcium deficiency is not caused by PMS but already present. It is only revealed by the flood of ovarian hormones (like estrogen) that occurs during the menstrual cycle.
However, PMS is more than a simple state of calcium deficiency. According to the reviewer, a more accurate description of the calcium imbalance in PMS is calcium dysregulation that is worsened by vitamin D deficiency and secondary hyperparathyroidism.
The final proof for calcium imbalance as a cause of PMS is in the clinical observation that calcium supplementation reduced most of the symptoms of PMS.
A 2005 study published in the Archives of Internal Medicine built on the results of past studies to determine whether calcium supplementation can prevent PMS.
For the study, the researchers took the data for women aged 27 – 44 years who partook in the the Nurses’ Health Study II Cohort to determine the effects of calcium and vitamin D supplementation on the risks of developing PMS.
The women selected for this study had no history of PMS before the study. However, over the 10-year period of follow-up, 1057 of them developed PMS while 1968 did not.
Calcium and vitamin D intake were accessed 3 times during the 10-year period with food questionnaires.
The results of this study showed that the women with the highest intakes of calcium and vitamin D had the lowest risks of PMS. In addition, the intake of skim or low-fat milk was associated with lower risks of PMS.
This study indicates that high intakes of calcium and vitamin D can help prevent PMS. It further confirms the theory that PMS is caused by calcium and vitamin D deficiencies.
In addition, the study proves that women with PMS can both prevent and manage their symptoms by eating more foods rich calcium and vitamin D and perhaps even taking calcium and vitamin D supplements.
Women can boost their calcium and vitamin D intake with fermented milk products such as yogurt and with green leafy vegetables such as spinach. Since the recommended calcium intake for women is 1200 mg, women with PMS should aim for that amount of daily calcium either from foods or supplements.
Magnesium is closely tied to calcium utilization in the body. In fact, magnesium controls the entry of calcium into every cell of the body.
The importance of magnesium to the roles of calcium is highlighted by how much the body needs this mineral to drive calcium to the bones. In the same way that magnesium promotes the mineralization of the body, it is also essential to all the benefits of calcium in PMS discussed above.
Researchers found that women with PMS also commonly suffered from magnesium deficiency.
Low levels of magnesium has been linked to a number of diseases include asthma, osteoporosis and diabetes.
Magnesium deficiency shares symptoms like fatigue, insomnia and muscle cramps with PMS. Severe magnesium deficiency can also cause calcium deficiency and hypoparathyroidism.
Because an estimated 57% of the US population does not get enough magnesium from their diet, magnesium deficiency is likely to be a significant cause of PMS.
In a 1991 study published in the journal, Obstetrics and Gynecology, a group of researchers successfully treated PMS mood changes with oral magnesium supplements. For the study, they recruited 32 women with PMS aged 24 – 39 years.
These women were monitored for 2 months during which their baseline PMS symptoms and magnesium levels were measured. Then they were randomly divided into 2 groups.
While one group received magnesium (magnesium pyrrolidone carboxylic acid containing 350 mg of elemental magnesium given 3 times daily), the other group was placed on a placebo.
They were given supplement or placebo from the 15th day of their menstrual cycles to the onset of menstrual flow. This treatment was also repeated during the next menstrual cycle.
The results of the study showed that the magnesium supplementation raised blood magnesium levels in the treatment group. The placebo group showed no such increase in magnesium level.
In addition, magnesium supplementation reduced pain and relieved symptoms related to mood changes.
A 2007 study published in the journal, Clinical Drug Investigation, investigated the efficacy and safety of a modified-release magnesium supplement in the treatment of PMS.
The researchers recruited 41 women with PMS aged 18 – 45 years. After observing them for 3 months, they were given a 250 mg tablet of the modified-release magnesium supplement (Sincromag) from the 20th day after their last menstrual cycle to the onset of the next menstrual cycle.
This trial of the magnesium supplement covered 3 menstrual cycles.
At the end of the 3rd month, the results of this open-label study showed that magnesium supplementation relieved PMS symptoms. In addition, the study also demonstrated that at once daily modified-release magnesium supplement can effectively and safely help women with PMS.
Vitamin D is often discussed in relation with PMS along with calcium. This is because vitamin D is essential to the absorption and utilization of calcium in the body.
In addition, vitamin D deficiency can cause PMS by promoting calcium deficiency. The calcium-vitamin D link to PMS is fully discussed above.
However, vitamin D can do more for women with PMS than simply improve the uptake of calcium.
In a study published in the Archives of Internal Medicine in 2012, a group of researchers recruited 40 women to investigate the benefits of high-dose vitamin D for relieving PMS symptoms.
These women all had low levels of vitamin D at the beginning of the trial. Thereafter, they were divided into 2 groups. While one group got placebo, the other group was given 300,000 IUs of vitamin D3 per day for 5 days before the start of their menstrual period.
This treatment was repeated during the next month. After each administration, the researchers measured pain scores in all the women.
At the end of the trial, the women who received vitamin D3 had their average pain score drop by 41%.
The women in placebo group experienced no change in pain score. In addition, none of the women in the vitamin D group took painkillers during the treatment. In contrast, 40% of the placebo group took painkillers at least once during the study period.
But how can vitamin D3 help reduce menstrual pain and PMS cramps? By inhibiting the production of prostaglandins.
Although vitamin D is definitely beneficial in the treatment of PMS, such high doses are generally not recommended because of the increased risk of hypercalcemia and organ damage.
The recommended daily intake of vitamin D is 400 IU and 4,000 IU is set as the upper tolerable limit.
There is conflicting evidence regarding the benefits of vitamin B6 for women with PMS. Most of the studies done in this area are criticized for their poor designs.
A 1987 study published in the journal, Obstetrics and Gynecology, is one of the better designed studies to investigate the use of vitamin B6 for PMS. In that study, the researchers gave vitamin B6 supplements to 55 women with moderate to severe PMS mood changes over a period of 2 months.
The results showed that vitamin B6 improved symptoms related to behavioral changes as well as a few physical symptoms. However, the improvement was far from total.
Other studies have found similar benefits especially when high doses of vitamin B6 were used. However, concern about the potential nerve toxicity caused by vitamin B6 above 100 mg/day makes it difficult to recommend high doses of the vitamin.
A 1999 review of 9 past studies involving 940 women with PMS concluded that although the studies were limited by their poor designs, the available evidence suggests that vitamin B6 supplementation up to 100 mg/day can reduce PMS symptoms especially premenstrual depression.
These studies indicate that vitamin B6 can provide some relief for the following PMS symptoms: moodiness, irritability, anxiety and bloating.
A 2007 study published in the International Journal of Obstetrics and Gynecology suggests that vitamin B6 may help improve PMS mood symptoms because of its role as a cofactor in the syntheses of neurotransmitters.
The evidence for the benefits of vitamin E for women with PMS is even smaller than that for vitamin B6. However, vitamin E supplementation for PMS is only a new area of research and almost of the studies investigating its benefits have been positive.
One double-blind study found 400 UI per day of vitamin E to be effective for reducing PMS symptoms.
The symptoms improved by vitamin E supplementation are breast pain and breast tenderness.
Given the fact that vitamin E deficiency causes nerve damage and muscle damage, it is likely that the modest benefits of vitamin E supplementation can help improve the pain and muscle fatigue associated with PMS.
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