H Pylori: 50% globally infected

The effectiveness of Vitamin B6 in the treatment of PMS dates back over 40 years. Results were noted, such as:

• ‘Significant decreases in all symptoms’ (1)
• 70% reporting good or partial response’ (2)
• ‘Improvement in 63% of patients on pyridoxine’ (3)

The dose used within these studies ranged from 40-200mg (with a possible risk of toxicity at 200mg).

Only one patient of the 940 participating in these trials indicated the presence of any side effects that could be attributed to the neuropathy associated with pyridoxine toxicity. (4)

A meta-analysis of nine published trials involving almost 1,000 women with PMS found that vitamin B6 is more effective in reducing PMS symptoms than placebo. (5)

A double-blind, randomized controlled trial in 94 women found that 80 mg pyridoxine taken daily over the course of three cycles was associated with statistically significant reductions in a broad range of PMS symptoms, including:

• Moodiness
• Irritability
• Forgetfulness
• Bloating
• Anxiety (6)

Below are my preferred dietary sources of Vitamin B6 per 100g:

• Liver – 1mg
• Salmon – 0.9mg
• Sunflower Seeds – 1.33mg
• Pistachios – 1.7mg

The recommended daily allowance sits around 1.3mg, which makes an easy target to obtain via food.

However, to achieve the dosage used in the above studies is between 30-153 times higher than the RDA, making it unachievable to obtain through diet alone.

As you can see here, Designs For Health provides 50mg of Vitamin B6 in just one capsule. This is in the form of Vitamin B6 in its most bioavailable form – P5P.

Magnesium and Vitamin B2 are required for the conversion of P5P. The deficiency rates of magnesium make this conversion much harder.

High protein diets or genetic susceptibilities (such as NBPF3) are factors that can increase the need for more Vitamin B6.

Have you ever used B6 for your PMS?

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References:

1. Goei and Abraham, 1983
2. Brush, 1988
3. Day, 1979
4. London RS, et al. 1991
5. Wyatt KM, et al. BMJ 1999
6. Kashanian M, et al. 2007

Depression is a complex disease with multiple contributing factors. The diagnostic criteria for depression include:

• Depressed or irritable mood
• Decreased interest in pleasurable activities and ability to experience pleasure
• Significant weight gain or loss (>5% change in a month)
• Insomnia or hypersomnia
• Psychomotor agitation or retardation
• Fatigue or loss of energy
• Feelings of worthlessness or excessive guilt
• Diminished ability to think or concentrate
• Recurrent thoughts of death or suicide
  (Berton O, et al. Nat Rev Neurosci. 2006)

Chances are that you have felt several of the above criteria but yet you may not have associated it with depression.

This is because depression is a broad term that may affect one person differently to the next, along with having a diverse range of possible causations.

Below is a list of some of the factors that can lead to depression and apathy:

• Trauma
• PTSD
• Abuse
• Post-natal depression
• Adverse childhood exposure
• Lack of safety
• Economic struggles
• Autoimmunity
• Social isolation
• Heartbreak
• Social media
• Lack of purpose
• S.A.D – Seasonal Affective Disorder (Vitamin D deficiency)
• Mold exposure
• Anaemia
• Sex hormone imbalances (Low/high oestrogen, low testosterone)
• Hypo/hyper thyroidism
• Stress
• Pain
• Chronic illness
• Genetic traits
• Methylation issues
• Heavy metal toxicity
• Parasites
• Nutrient deficiencies (B6, etc)
• Nutrient excess
• Artificial light exposure
• Poor sleep
• Mitochondrial dysfunctions
• Poor gut health
• Gut/brain axis inflammation
• Cytokine model of depression
• Medication
• Loss of a loved one
• Divorce
• Substance abuse
• Neurotransmitter imbalances
• Lyme
• Toxic and ambivalent relationships

Each reason, being so unique, may require a completely different approach for therapy from the next.

This reverberates a quote of William Osler, stating ‘It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has’. Unfortunately, society generally neglects the beauty of individuality whilst overlooking the crucial interplay and synergy from the multifactorial systems essential for optimal function within our body.

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PMS is characterised by a collection of physical and emotional symptoms that occur in the day before menstruation.

(Awanish Kumar Pandey, et al. 2013) indicated that 100% of girls tested showed a prevalence of at least one symptom of PMS, with 42.5% showing more than five symptoms.

Some of the most common psychological symptoms ranged from:

• Lethargy (83%)
• Anger and hypersomnia (74%)
• Anxiety (68.5%)
• Feeling overwhelmed (62.5%)
• Hopelessness (50%)
• Difficulty in concentrating (33.5%)
• Tearfulness (26.5%)
• Insomnia (26%)

Some of the most common physical symptoms ranged from:

• Joint or muscle pain (77.5%)
• Headaches (67%)
• Weight gain (58%)
• Backache (57.5%)
• Bloating (41%)
• Breast tenderness (31%)
• Acne (*16.5%)

*16.5% may seem low when compared with some of the other figures mentioned above, however, this still equates to 1/6 women suffering from acne every single month around their menstruation.

The conventional approach for addressing PMS uses SSRI’s, which numbs the individual along with increasing the likelihood of suicide ideation, risks post-SSRI-sexual-dysfunction and depletes melatonin.

This complex condition likely has multiple causes, with fluctuations in hormone levels and nutritional deficiencies playing key roles.

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OESTROGEN

One of the possible reasons for PMS has been associated with the excess of oestrogen relative to progesterone.

High oestrogen has also been found to increase thyroid-binding-globulin, which will reduce the activity of the thyroid hormones, further leading to apathy and a lack of energy. Ensuring oestrogen’s efficient metabolism through the correct pathways and supporting elimination from the body is paramount.

In short, this requires a range of nutrients from cruciferous vegetables, flaxseed and possibly grapefruit (grapefruit does have the ability to inhibit CYP3A4 enzyme which will decrease the metabolism of medication. Therefore grapefruit should be avoided to prevent medical complications).

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PROGESTERONE

Progesterone is also at its lowest during the time of PMS. Progesterone acts on GABA receptors in the brain to produce a calming effect along with supporting thyroid conversion, thus assisting with energy.

The consumption of Wild Yams supports progesterone.

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MAGNESIUM

Magnesium deficiencies may be causing or aggravating symptoms of PMS. Magnesium is essential for nerve, muscle function and the ability for the muscles to relax, all of which can be affected in PMS. (Iran J Nurs Midwifery Res. 2010 Dec).

A decrease of 12.42% in serum magnesium levels have been found in the follicular phase when compared to the menstruation with magnesium levels elevating a further 7% in the luteal phase. These fluctuations portray the role of magnesium in accordance with menstruation. Magnesium can be obtained through the consumption of dark chocolate or almonds.

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IRON

In a meta-analysis, eating an iron-rich diet was linked to a 31% lower risk of developing premenstrual syndrome (Am J Epidemiol. 2013 May). Iron will be depleted during menses, thus further depleting levels. Iron is essential for energy regulation, along with being an essential a cofactor for the enzyme tryptophan hydroxylase, which catalyses the conversion of tryptophan into 5-hydroxytryptophan, a precursor for serotonin (the neurotransmitter associated with mood and happiness).

Iron obtained from plants is likely to have reduced bioavailability within the body. It is often accompanied by phytic acid and oxolates, both of which bind with the iron to prevent absorption.

Another factor to take into account when seeking to optimise iron levels within the body is stomach acid (HCl). HCl is essential to break iron down from food for assimilation within the body.

One can complete the baking soda challenge test for indication of whether their HCl is low or not, by drinking 250ml of water mixed with 1/4tsp of baking soda first thing in the morning. If the individual belches after the 3-minute mark, this would correlate to low HCl and therefore a likelihood that the individual will have poor digestion and assimilation of iron within their body.

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ZINC

Women have a 24%–29% lower risk of PMS when in the top 2 quintiles of zinc to copper ratios (Am J Clin Nutr. 1995). Zinc deficiency is associated with depression while copper up-regulates the CYP19A1 enzyme, which leads to aromatisation of androgens to oestrogen (estradiol) while enhancing estradiol binding affinity to the oestrogen receptors, which amplifies its action.

Below are my preferred dietary sources of zinc per 100g:

• Oysters – 61mg
• Beef – 11mg
• Hemp Seeds – 10mg

Zinc is another micronutrient which requires HCl for its assimilation, therefore assessing HCl status could also correlate with the potential zinc status within the individual.

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VITAMIN B6

The effectiveness of Vitamin B6 in the treatment of PMS dates back over 40 years. Results were noted such as ‘significant decreases in all symptoms’ (Goei and Abraham, 1983), ’70% reporting good or partial response’ (Brush, 1988) and an ‘improvement in 63% of patients on pyridoxine’ (Day, 1979). The dose used within these studies ranged from 40-200mg (with possible risk of toxicity at 200mg).

Only one patient of the 940 participating in these trials indicated the presence of any side effects that could be attributed to the neuropathy associated with pyridoxine toxicity (London RS, et al. 1991).

Obtaining this level of Vitamin B6 effectively through food will be extremely difficult as these dosages are 29-115 times that of the recommended daily allowance.

Below are my preferred dietary sources of Vitamin B6 per 100g:

• Organic liver – 0.6mg
• Pistachios – 1.7mg
• Salmon – 0.9mg

Above is just an example of how proper nutrition can support and mitigate against PMS.