Feel Better Each Month with Dr. Jonny’s PMS Cocktail
AS ANYONE WHO has experienced it knows well, PMS is no picnic. It’s also—let me be very clear—not “all in your head.” It’s the product of a real hormonal turbulence that accompanies the menstrual cycle, more in some people than in others, and it can cause significant mood swings, crying jags, depression, anger, and irritability, not to mention a compendium of physical symptoms like bloat, constipation, and terrible cramps.
That hormonal storm, which can be a light tropical rain for some folks and Hurricane Katrina for others, also affects neurotransmitters like serotonin, influencing mood, cravings, and behavior. The combination of nutrients I’m about to tell you about works wonders.
The Dynamic Duo: Magnesium and Vitamin B6
Let’s start with magnesium. Supplementation with magnesium can improve mood and also help with fluid retention.
In one of many studies, supplementation with 360 mg of magnesium three times a day (just a little more than the amount in my recommended PMS cocktail) produced significantly improved scores on the Moos Menstrual Distress Questionnaire, leading the researchers to conclude that magnesium supplementation could represent an effective treatment of premenstrual symptoms related to mood changes.
Vitamin B6 has long been observed to be part of a comprehensive nutritional support package for PMS. The body needs B6 to make serotonin out of the amino acid tryptophan, and many people are low in B6 (as well as other B vitamins) because of stress, which literally eats up B vitamins for breakfast! And who couldn’t use more relaxing, calming, crave-busting serotonin? Research shows that supplementing with B6 up to 100 mg a day is very likely to be of benefit in treating premenstrual symptoms and premenstrual depression.
One study in the Journal of Women’s Health and Gender-Based Medicine tested various combinations of B6 and magnesium and found that both B6 and the B6-magnesium combo were helpful in reducing mild PMS-related anxiety symptoms. This study was all the more interesting because they used a crappy kind of magnesium—magnesium oxide—and a low dose to boot, but folks still reported improvements. A high-quality magnesium at the 800 mg dose I recommend, together with B6, would be likely to produce even better results.
Using the Right Dose of Evening Primrose Oil
Evening primrose oil (like borage oil and black currant oil) is a natural source of a fatty acid called GLA—gamma-linolenic acid. This is one of those supplements for PMS that thousands swear by but is lacking in good scientific research that shows that it works. That may be because most of the studies on it used a preparation that contained only 40 mg of GLA, which is too low to have any real effect on PMS symptoms.
The average 1,000 mg dose of evening primrose oil contains about 100 mg of GLA. My “cocktail” would provide at least 200 mg (if not more) of GLA a day. It may also be true that GLA works best in combination with B6 and magnesium and is not quite as effective on its own. Because GLA is a natural anti-inflammatory, and because many people find it helpful for PMS, I think you should include it in the cocktail.
There is good scientific evidence for the use of calcium in easing PMS. A lot of research suggests that calcium and vitamin D supplements may reduce the severity of PMS, and there appears to be a link between PMS and low dietary calcium intake. Taking 1 to 1.2 g of calcium daily seems to really reduce depressed mood, water retention, and pain.
In one study, women consuming an average of 1,283 mg of calcium a day from foods had about a 30 percent lower risk of developing PMS compared to women consuming much less (529 mg). A more recent study, in the Archives of Internal Medicine, saw a 40 percent lower risk of PMS developing in women with high intakes of vitamin D and calcium. Considering all the other great things vitamin D does—such as its role in cancer prevention and bone health—and considering that most of us get far too little of it, vitamin D supplements are a good idea.
Remember, if you want to increase your calcium intake, dairy is hardly the only way to do it, though the dairy industry would have you believe it is the best way. It’s not. Adding more dairy to your diet opens up a whole other can of worms that you may not want to open (see the section on dairy in my book The 150 Healthiest Foods on Earth), and it may even aggravate PMS symptoms. Green leafy vegetables, sardines, and seeds (such as sesame or pumpkin) are full of calcium, and there are always supplements (be sure to take magnesium at the same time).
Krill are little crustaceans that look like shrimp and provide food for everything from salmon to blue whales. Their oil is rich in omega-3s, antioxidants, and vitamins; there’s good evidence that krill oil can help reduce the symptoms of PMS.
In a double-blind, randomized clinical trial, seventy patients diagnosed with PMS (using the standards of the Diagnostic and Statistical Manual of Mental Disorders, third edition, revised) were treated for three months with either krill oil or plain old omega-3 fish oil. The krill oil group had a statistically significant improvement in dysmenorrhea (painful menstruation) as well as in the emotional symptoms of PMS. The women taking the krill oil also chose to consume significantly less painkillers during the treatment period. JMS Medical Research, the independent research organization responsible for the data analysis, reported that krill oil “significantly improves the overall emotional and physical symptoms of patients suffering from premenstrual syndrome.”
This study was particularly interesting because it not only investigated the effect of krill oil on PMS, but it also compared the effect of krill oil to regular omega-3 fish oil. Krill oil won. You’d expect omega-3s in general to have a good effect because of their anti-inflammatory action, but possibly other components in the krill oil work synergistically with the omega-3s.
The dose of krill oil found to be most effective is 3 grams a day. The single downside: Neptune Krill Oil is expensive.
The herb chasteberry (vitex) has been used for more than 2,500 years in Egypt, Greece, and Rome for a variety of conditions, not the least of which was decreasing libido (making it popular among celibate clergy but kind of a drag for the rest of those folks). It’s widely prescribed in Germany, where the esteemed German Commission E approves it for irregularities of the menstrual cycle and PMS.
Taurine, an amino acid, is a natural diuretic and the best way I know to reduce bloat. One product I use (available through my website) is called Water Ease, and it’s almost pure taurine (with a little B6 thrown in for good measure). For water retention I recommend 900 to 1,000 mg of taurine when needed.
And don’t forget diet: A great deal of research supports the idea that diet can profoundly affect PMS symptoms. Coffee and alcohol may make things worse. Sugar almost certainly does. Tory Hudson, N.D., a highly respected expert in the field of women’s health, wisely recommends a diet of fruits, vegetables, whole grains, legumes, nuts, seeds, and fish, and the avoidance of refined sugar, dairy, salt, tobacco, and caffeine. It might be hard to follow, but it’s sure to work.