Helping PMS Naturally - Premenstrual Syndrome

posted on 22 November 2007 | posted in In Depth Articles

Helping PMS naturally - the vegetarian connection

We used to treat PMS solely nutritionally along standard lines with moderately good results. However, we sometimes found pyridoxal 5 phosphate to be superior to pyridoxine, and also felt it necessary to use magnesium supplement (we use Magnesium Supreme in our clinic) to overcome the problems of poor bioavailability that we encountered with this mineral.

We later discovered the value of herbs, and nowdays add the herbal formula Agnus Castus Plus to the nutritional package. (Herbs are also very helpful in the treatment of the related condition, dysmenorrhoea) However, the real breakthrough for us, particularly in treating recalcitrant cases, came with the discovery of the Candida connection, to which Dr Lewis insightfully draws attention.

We use herbs to deal with the Candida and usually precede treatment with a regime designed to lower the level of Candida Toxins in order to alleviate symptoms as quickly as possible and to minimise die-off problems. For more information about candida please read this article

With regard to the premise that PMS is frequently a manifestation of oestrogen overload, I should like to elaborate on the point mentioned by Dr lewis that vegatarians have lower oestrogen levels than omnivores. In our artificial society it is so often overlooked that human anatomy and physiology doesn't even remotely resemble that of a carnivore. indeed, analyses of other primate diets suggest that we should derive about 1.5% of our calories from animal sources instead of the current level in the West of about 50%. Thus at the very least, meat should be used as a condiment rather than an ailment.

Vegetarins suffer a lower incidence than omnivores of a whole host of diseases, and it looks as though PMS could be one of them. Indeed, there are several possible mechanisms whereby a vegetarian diet could reduce hyperoestrogenism:

The metabolic precursor of oestrogen is cholesterol, and a vegetarian diet is low in this sterol, while a vegan diet is devoid of it.

A vegetarian diet is low in arachidonic acid, which is a precursor of prostaglandin F2-alpha, which is pro-oestrogenic by virtue of its luteolytic effect.

Vegetarians tend to have higher intakes of vitamin B6 and magnesium, both of which are believed to enhance the hepatic inactivation of oestrogen.

A vegetarian diet substantially increases the faecal excretion of oestrogen through several mechanisms (vide infra).

Vegetarians are likely to eat more cruciferous vegetables (cabbage, brussels sprouts, broccoli, cauliflower, kale, turnip, swede, radish, horseradish, mustard and cress) than meat-eaters, and the indole constituents of these (particularly indole 3 carbinol) shift the balance of oestrogen metabolites towards the inactive 2 hydroxylated derivatives away from the active 16 hydroxylated derivatives, thus attenuating the oestrogenicity of the parent molecule. Using the protein drink SynerProTein that contains high quality protein and vegetable extracts of the above, this can help

(Vegatarians tend to eat less fat, and a low fat diet similarly shifts the balance in favour of the 2-hydroxylated derivatives). Other chemicals found in cruciferous vegetables (such as sulforaphane) up-regulate hepatic glucuronidation and sulphation, and since the liver conjugates oestrogens that have played out their role in the body to form glucuronides and sulphates (mainly glucuronides) such as enzyme induction should assist in the excretion of oestrogens.

A vegetarian diet is likely to be higher in oestrogen-normalizing phytonutrients, the best known examples of which are lignans (vide infra) and soya isoflavones.

Vegetarianism limits exposure to the high levels of naturally occurring oestrogens found in meat, offal and cows milk. Some workers dispute the bioavailability of such oestrogens, but I believe that the true picture has yet to be established.

Pesticides, some of which are oestrogenic (either intrinsically or by enhancing the 16-hydroxylation of endogenous oestrogens), concentrate at the top of the food chain, so restricting foods such as meat, milk and eggs will reduce exposure to these xeno-oestrogens.

A substantial proportion of the oestrogens that have been conjugated in the liver glucuronidated or sulphated) is excreted in the bile and thence the stool (the remainder being excreted in the urine). If, however, the colon harbours an excess of "bad" putrefactive bacteria such as Bacteroides species (putrefactive dysbiosis) there is an in the baterial enzyme (beta-glucuronidase) that can deconjugate excreted oestrogens and an increase in blood levels.

This type of dysbiosis arises as a conequence of eating a diet high in fat and meat and low in fibre, and is therefore corrected by decreasing dietary fat and meat, and increasing fibre consumption, which is presumably why vegetarians have much lower levels of intestinal beta-glucuronidase activity. (Supplementing the "friendly" bacteria, Lactobacillus acidophilus and Bifidobacterium bifidum, may also be necessary).

Those with a high fibre intake tend to have mostly good bacteria in their intestines because fibre feeds good bacteria, which then displace bad bacteria, and because fibre acidifies the colon by producing short-chain fatty acids, thus encouraging growth of the good "acidophilus" (acid-loving) bacteria. Further, the increased faecal bulk and decreased transit times of women consuming a high fibre diet discourage deconjugation and reabsorption of oestrogens, and what is more, some types of fibre (especially cellulose) actually bind intestinal oestrogens thereby inhibiting their re-absorption. Additionally, lignans (which are substances found in the fibre rich fraction of certain plants, especially seeds and grains - notably linseed, barley and rye) are changed by the gut flora to the anti-oestrogens enterolactone and enterodiol, which are then absorbed and exert a protective effect against hyperoestrogenism.

My own advocacy of fibre goes back many years to the days of the pioneering work of Surgeon-Captain Cleave. I reviewed Cleave's seminal book The Saccharine Disease in the Journal of Tropical Medicine and Hygiene in 1974 and subsequently was privileged to receive much instruction from this delightful and sometimes eccentric iconoclast. Sadly, although Cleave's work was respected by many, it didn't really receive the recognition it deserved until Denis Burkitt took up the cause. Burkitt commanded worldwide respect because of his work on the lymphoma named after him, and he therefore lent considerable authority to the fibre story, which is still unfolding even to this day.

Fibre deficiency has been linked to the causation of some twenty diseases ("little stools, big hospitals, big stools, little hospitals"). The average fibre intake in the West is around 12g daily, but an intake of 25-35g is considered optimal. (The recommended daily intake in the UK is 18g). Even those who claim to consume a good wholefood diet mostly test as being fibre deficient in our hands (which raises questions as to the relaibility of self-assessments as well as the virtue of coked fibre), and it is for this reason that we have formulated a mixed fibre supplement, which can help achieve the necessary intake.

I would urge those treating PMS (and other conditions believed to be caused by hyperoestrogenism such as dysmenorrhoea, menorrhagia, metrorrhagia, endometriosis, fibroids, cystic breast disease and breats cancer) to consider the wholefood vegetarian/vegan option in an attempt to address what could be one of the root causes of this distressing but eminently treatable malady.

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Helping PMS Naturally - Premenstrual Syndrome