Nutritional Management of PMS

by Michael Ancharski, N.D.

Formerly Clinical Director of the Outpatient Teaching Clinic

at the National College of Naturopathic Medicine

edited by Dr. M. Moribund (with explanatory notes by the editor)

ingredients of

 Opti Gyn Formula

are below article

P

re-menstrual syndrome affects between 20 and 90% of women of reproductive age (depending on the researcher’s criteria for symptoms and severity). 

 

     40% (12 million women in the US) are found to have any combination of the  following major symptoms to a degree that markedly disrupts their lives during the pre­menstrual phase of their cycle:

80% - irritability/ anxiety;

60% - CHO (Carbohydrate) craving;

40% -  bloating/edema;

20% - depression;

Variable - fatigue, headache, Insomnia, breast swelling, and mastalgia –(breast pain), constipation, acne, violent behavior, and cramping.

 

Risk factors include:

 

1.   Late 20’s - early 30’s.

2.   High in parity.

3.   Low exercise.

4.   Poor diet (excesses of Sugar, coffee, alcohol, fats and preservatives).

5.   Marriage.

6.   High Stress (high estrogen years).

7.   Toxemia of pregnancy.

8.   Irregular menses.

9.   Poor drug tolerance such as BCP-(birth control pills), antibiotics.

10.Post partum depression.

11.Overweight.

 

Historical Investigation of PMS Etiology-(causes)

 

      Frank in 1931 initially found high serum estrogen and low estrogen metabolites in urine, or unopposed estrogen buildup.  Israel (1938) found hyper- proliferative endometrium-(build-up of the wall of the uterus), demonstrating relative progesterone deficiency. (Meaning the high estrogen is unopposed). Later studies (Greenhill, Bickers, Mukherjee) attributed PMS to water retention secondary to high estrogen and disrupted salt and fluid mechanisms, possibly adre­nal.

 

       Sufferers of PMS were found to be B vitamin deficient in the 1940’s (Biskind), causing dysfunction of many biochemical path­ways that B vitamins were cofactors in, including estrogen conjugation in the liver. {In other words low B-Vitamins caused the liver to not be able to remove Estrogen once it was no longer needed.  Thus leading to a build-up of Estrogen in the blood}.

 

      Vitamin A (Simkins 1947) deficiency has been associated with decreased thyroid levels and increased estrogen levels.

 

       PMS subjects demonstrate hyperinsulinism secondary to decreased adrenal function causing a reactive hypoglycemia (Morton 1952) with a flat GTT {glucose tolerance test), curve. Also noted was a melanocyte stimulating hormone increase which lowered dopamine, {What Dr. Ancharski is saying is that in high estrogen conditions melanocytes, (the cells that make the brown skin pigment Melanin) are stimulated.  Since both Melanin & dopamine are made from the same amino acid – Tyrosine, by simulating the production of Melanin the body is using up the available Tyrosine which means there won't be enough to make adequate quantities of dopamine, the excitatory neurotransmitter, thus leading to depression}, irritability and water retention.

 

Current Understanding Of Etiology and Treatment:

 

       Adams and Abraham have recently demonstrated that 300-500 mg Vitamin B-6 per day significantly improves PMS symptoms. B-6 serves as a co-factor for EFA {essential fatty acids}, metabolism, is important in dopamine formation and for gluconeogenesis. B6 also acts as a diuretic, reducing hyper permeability of cell membranes which decreases interstitial fluid shifts.

 

      As a cofactor for dopamine production, B-6 helps regulate prolactin (dopamine suppresses prolactin) and as a cofactor for serotonin production, B6 helps stabilize mood swings. Estrogen rise results in relative B-6 defi­ciency, because it releases hepatic enzymes which compete for B-6. Supplementation with B6 improves hepatic clearance of estrogen.

 

       Magnesium deficiency (American Journal of Clinical Nutrition, 1964), common in the U.S. and found in PMS, causes hyperplasia of the zona glomerulus in the kidneys leading to water retention. It also causes hyperirritability to muscles, {Magnesium relaxes the involuntary muscles}, and emotional state and increased urination. The suggested calcium to magnesium ratio is 1:1 and at 600 mg per day has been found to significantly reduce many PMS symptoms.

 

       In the Journal of Reproductive Medicine, Volume 28, 1983, Horrobin outlines the crucial role of EFA (essential fatty acids) and GLA, {Gamma Lenoleic Acid}, in PMS. PMS sufferers demonstrate higher sensitivity to and or higher levels of prolactin and low PGE-1 {Prostaglandin-E-1} in their blood. PGE-1 counteracts the effects of prolactin.  (which when elevated pro­duces PMS symptoms). PGE-1 also reduces the dysmenorrheic properties of the series-2 prostaglandins. {PGE-2}.

 

       Dietary linoleic acid and GLA {Gamma Linolenic Acid},  are converted to PGE-1 through a biochemical pathway that requires the following cofactors at different steps: B6, Magnesium, Vitamin C, Niacin, & Zinc. This pathway can be disrupted

 by too much dietary intake of saturated fats, alcohol, the catecholamines {stimulants}, of stress, or by the lack of available co-factors.  Excellent sources of GLA include Borage, Black Currant, and Evening Primrose oils.

 

Excess estrogen enhances the aldosterone {Aldosterone is the hormone that controls what amount of minerals are retained when you excrete water via the Kidneys}, system (renin, angiostensin) causing fluid and salt retention. Mastalgia and fibrocystic breast disease exhibit low iodine levels which are associated with increased estrogen.  Hypothyroid women have increases of mastalgia and FBD {fibrocystic breast disease} due to resultant increased circulat­ing levels of estradiol. (JAMA, June 1966).

 

Abraham in 1965 demonstrated the use of 400 IU of Vitamin E effective in the treatment of FBD {fibrocystic breast disease} as well as the relief of many PMS symptoms. Vitamin E and Selenium prevent oxidation of EFA {essential fatty acids}, adrenal and sex hormones.

 

Due to the relative ineffectiveness of progesterone administration in relieving PMS symptoms (Sampson 1979) one must concentrate on methods of reducing excess estrogen, specifically estradiol. Slower {bowel}, transit time leads to higher estradiol, therefore the addition of mild laxatives (such as Cascara) and dietary advice to treat constipation and liver congestion is warranted.

 

Excess weight reduces the clearance of estrogen. Caffeine and other Methyl-xanthenes inhibit enzymes, raise kinin and hista­mine levels and lower B-1; all resulting in estradiol buildup.

 

      The hyperinsulinism and resultant hypoglycemia associated with PMS make chromium and manganese supplementation important. Blood levels of calcium have been shown to drop the 14 days before the menses, and calcium relieves the insomnia, cramps and headache symptoms of PMS. Zinc deficiency is common in PMS, causing irritability, depression and skin changes - it is also critical for the utilization of B-6 and EFA.

 

      From a naturopathic and clinical standpoint effective estrogen reduction begins by cleansing the liver where its conjunction for excretion takes place. The lipotropic factors, Choline, Methionine, (a sulphur containing Amino Acid), and Inositol, and the botanicals Berberis, (Oregon Grape Root), Chelidonium, (Celandine), Silybum, (Milk Thistle), and Taraxacum, (Dandelion), improve liver function by lowering blood triglycerides, improving hepatic circulation, improving digestion and excretion, decreasing hepatic congestion and torpor, promoting bile formation and cholagogue activity and aiding weight loss.

 

      Dong Quai is a time honored menstrual hormone “regulator.” -      it acts as a sedative for irritability and cramping, reduces headache incidence, is a cerebral nerve tranquilizer, and according to Chinese medical literature ‘purifies the blood and ‘regulates the cycle’.

 

    Sarsaparilla contains steroidal sapogenins, precursors to progesterone production (as do Mexican yams and soybeans). it also serves as an excellent general tonic, alterative and diuretic.

 

Vitamin C enhances the activity of enzyme pathways and strengthens cell wall integrity (decreasing abnormal permeability). Bioflavinoids have anti-histamine activity and inhibit estrogen by competing for receptor sites.

A low level of Vitamin D is important for the utilization of calcium. Folate should be low, because it potentiates estrogen, while PABA should be low because it has anti-thyroid properties (thyroid is an integral estrogen antagonist).

 

Copper is needed to balance the zinc and Betaine HCL allows for better absorption. Potassium acts as a diuretic and aids sodium balance (high sodium is associated with PMS).  Iron prevents anemia commonly seen in PMS patients.

 

     PMS had been increasingly associated with general malab­sorption, allergies and Candidiasis. When PMS is effectively treated, other hyper-estrogenic conditions such as fibrocystic breast dis­ease, ovarian cyst, uterine fibroids, and secondary hypothyroidism are improved or prevented.

 

     OPTI - GYN Formula has been specifically formulated to address the complete spectrum of nutritional factors involved in hyper-estrogenism and is exclusively available from ECLECTIC INSTITUTE. Also available: OPTI - NATAL, a high potency, hypo-allergenic pre-natal and lactation supplement.

 Opti Gyn Formula
W/O Iron, 112 tablets

Eight Tablets Contain:

  • Vitamin A (50/50 Palmitate & Beta Carotene) - 10,000 IU

  • Vitamin C - 1000 mg.

  • Vitamin D (Activated Ergosterol) - 50 IU

  • Vitamin E (Mixed Tocopherols including d-Alpha) - 400 IU

  • Vitamin B-1 (Thiamine HCL) - 50 mg.

  • Vitamin B-2 (Riboflavin) - 50 mg.

  • Vitamin B-3 (Niacinamide) - 50 mg.

  • Vitamin B-6 (Pyridoxine HCL) - 400 mg.

  • Folic Acid - 100 mcg.

  • Vitamin B-12 - 50 mcg.

  • Pantothenic Acid - 50 mg.

  • Calcium (Amino Acid Chelate) - 600 mg.

  • Magnesium (Amino Acid Chelate) - 600 mg.

  • Iodine (Kelp) - 300 mcg.

  • Zinc (Amino Acid Chelate) - 45 mg.

  • Selenium (Amino Acid Chelate) - 150 mcg.

  • Copper (Amino Acid Chelate) - 2 mg.

  • Manganese (Amino Acid Chelate) - 15 mg.

  • Chromium (Amino Acid Chelate) - 150 mcg.

  • Potassium (Amino Acid Chelate) - 99 mg.

  • PABA - 15 mg.

 
  • Choline (Bitartrate) - 450 mg.
  • Inositol - 300 mg.
  • Bioflavinoids - 200 mg.
  • Betaine HCL - 200 mg.
  • L-Methionine - 450 mg.
  • Borage Seed Powder (90 mg GLA) - 550 mg.
  • Dong Quai (Angelica sinensis) root - 500 mg.
  • Sarsaparilla (Smilax ornata) root - 500 mg.
  • Chaste Tree (Vitex agnus castus) berry - 400 mg.
  • Wild Yam (Dioscorea villosa) root - 200 mg.
  • Ginger (Zingiber spp.) root - 200 mg.
  • Dandelion (Taraxacum officinale) fresh freeze-dried root - 150 mg.
  • Oregon Grape (Mahonia aquifolium) root - 150 mg.
  • Celandine (Chelidonium majus) fresh freeze-dried leaf - 75 mg.
  • Beet (Beta vulgaris) fresh freeze-dried leaf - 75 mg.
  • Milk Thistle (Silybum marianum) seed - 60 mg.
  • Cascara Sagrada (Rhamnus purshiana) - 30 mg.
  • Also contains: Cellulose, vegetable stearine, silicon dioxide, magnesium stearate.
  • The same formula as Vita Gyn!