Phthalates and endometriosis

In a meta-analysis assessing the mineral intake of approximately 3,000 women. It found that eating an iron-rich diet (20mg per day) was linked to a 30-40% lower risk of developing premenstrual syndrome when compared to the lowest intake of iron (around 10mg per day) (Am J Epidemiol. 2013 May).

Menstruating women lose around 40% more iron per day when compared to men, with some studies stating how heavy menstrual bleeding is one of the leading causes of anemia in the developed world (Liu Z, et al. 2007).

The National Health and Nutrition Examination Survey indicates that 12-16% of non-pregnant women (aged 16-49 years) have iron deficiency, with 2-4% having anemia.

Increasing iron intake through diet and supplementation for two months has been shown to reduce PMS symptoms considerably in all anemic women (Mitesh Sinha et al. 2013).

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?

‍

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

Below are alternative methods which have been studied for their efficacy and effectiveness in combating postpartum depression.

‍

Saffron

A double-blind, randomised, placebo-controlled trial was conducted on 60 new mothers diagnosed with PPD. After 8 weeks, results showed that the saffron group experienced a 96% remission rate for postpartum depression from just 15-mg Saffron per day, more than double the remission rate of placebo group ‘Researchers concluded that saffron can have a safe and significant mood-elevating impact for those suffering from postpartum depression who want to safely breast-feed their newborns’ (8)

When compared with antidepressant medications, saffron has been found to have similar efficacy – without the side effects.

‍

Folate

In placebo-controlled trials, folate has been used as an adjunctive treatment to fluoxetine. Findings indicated significantly greater improvement in the folate group, a difference most pronounced in women (14)

94% of women who received fluoxetine, with the addition of folate 500 mcg per day, were treatment responders, compared with 61% of those who received fluoxetine and placebo

It is recommended that women of reproductive age consume 0.4–1 mg folate daily to reduce the risk of neural tube birth defects.

‍

Exercise

Exercise is integral to optimal health in pregnancy, as well as in the prevention of heart disease, obesity, and diabetes, along with other comorbid diseases. Regular physical activity (after selectively auditing through 216 studies) during pregnancy, pregnancy, and puerperium, or in the postnatal period itself as compared to inactivity, was found to reduce the risk of developing depression in pregnant women and after the birth of a child (6)

‍

Massage

A meta-analysis of 17 RCTs of massage therapy in depressed people concluded that massage therapy is significantly associated with reduced depressive symptoms (11), decreased urinary levels of cortisol (12); and increased urinary levels of serotonin and dopamine (13)

The purpose of this post is to raise awareness and display the vast array of possible paths one could take in supporting their own mental well-being when combatting PPD.

‍

Infant Massages

Infant massage improves mother-infant interaction for mothers with postnatal depression (7)

‍

Seafood

In a large Danish prospective cohort study of more than 54,000 women, participants who were in the lowest quartile of self-reported fish intake during pregnancy were at increased risk of being treated for depression with an antidepressant up to 1-year postnatally (9). Rather than extrapolating this solely to benefits Omega-3, it is important to take into account that sociodemographic characteristics not only influence food availability in house-hold diets but also emotional statue

‍

Bright Light Therapy

In participants who received at least three weeks of bright light therapy each morning for 1-hr had improvements in their depression scores by a mean of 49%; among participants who completed at least 5 weeks, scores improved by 59% (10)

Caveats in this field of research are that the study pools are low most likely due to the ‘cost vs return’ of investing into studies in this sector

‍

References:

1. J Midwifery Womens Health. 2013 Nov-Dec; 58(6): 643–653.
2. Lindah l V, Pearson J L, Colpe L. Prevalence of suicidality during pregnancy and the postpartum. Arch Womens Ment Health 2005;8:77–87.
3. Phytomedicine. 2017 Dec 1;36:145-152. doi: 10.1016/j.phymed.2017.10.005. Epub 2017 Oct 7.
4. Clin Obstet Gynecol. 2009 Sep; 52(3):456-68.
5. Acta Obstet Gynecol Scand. 2001 Mar; 80(3):251-5.
6. Medicina (Kaunas). 2019 Sep 2 ;55(9). Epub 2019 Sep 2. PMID: 31480778
7. J Affect Disord. 2001 Mar;63(1-3):201-7. PMID: 11246096
8. J Integr Med. 2013 Nov;11(6):377-83. doi: 10.3736/jintegrmed2013056.
9. Strom M, Mortensen EL, Halldorsson TI, et al. Fish and long-chain n-3 polyunsaturated fatty acid intakes during pregnancy and risk of postpartum depression: a prospective study based on a large national birth cohort. Am J Clin Nutr 2009; 90:149–55.
10. Oren DA, Wisner KL, Spinelli M, et al. An open trial of morning light therapy for treatment of antepartum depression. Am J Psychiatry 2002;159:666–9.
11. Hou WH, Chiang PT, Hsu TY, et al. Treatment effects of massage therapy in depressed people: a meta-analysis. J Clin
    Psychiatry 2010;71:894–901.
12. Field T, Diego M, Hernandez-Reif M, et al. Pregnancy massage reduces prematurity, low birthweight and postpartum depression. Infant Behav Dev 2009;32:454–60.
13. Field T, Diego MA, Hernandez-Reif M, et al. Massage therapy effects on depressed pregnant women. J Psychosom Obstet Gynaecol 2004;25:115–22.
14. Coppen A, Bailey J. Enhancement of the antidepressant action of fluoxetine by folic acid: a randomised, placebo controlled trial. J Affect Disord 2000;60:121-30.
15. Mischoulon D, Fava M. Role of S-adenosyl-L-methionine in the treatment of depression: a review of the evidence. Am J Clin Nutr 2002;76:1158S 61S.
16. Roder C, Schaefer M, Leucht S. Meta analysis of effectiveness and tolerability of treatment of mild to moderate depression with St. John’s Wort [in German]. Fortschr Neurol Psychiatr 2004;72:330–43.

‍