PMS (premenstrual syndrome) is quite common among women of childbearing age and can easily make their lives miserable for years, causing both physical and mental discomfort several days a month. A possible cause can be lack of vitamin D, and it looks as if high-dosed supplementation with the nutrient can relieve PMS by controlling inflammation markers and influencing the body’s antioxidant capacity. This was shown in an Iranian study that is published in Scientific Reports. It is worth noting that we need magnesium to activate vitamin D in order for the body to be able to use it optimally.
PMS includes a number of symptoms, all of which occur between ovulation and menstruation. The most common symptoms are headache, despair, irritability, cognitive dysfunction, sugar craving, oedemas, poor sleep, tender breasts, and pain in the lower abdomen. These physical and mental symptoms have a negative impact on women’s quality of life and constitute a serious health problem in our modern society, according to the World Health Organization (WHO). Next of kin to a woman affected by PMS, including her spouse, children, and colleagues, may also suffer under her hormonal fluctuations. On a global scale, around 48% of women of childbearing age have PMS. Younger women are more susceptible and 70-90 percent have experienced at least one PMS symptom over the course of their fertile years.
PMS may be caused by inflammation, oxidative stress, and other imbalances
It is not possible to diagnose PMS by means of a blood sample. However, the American Psychiatric Association has listed several physical and psychological symptoms that are used as criteria for the diagnosis. There are, however, hypotheses that deal with imbalances in the primary gonadotropins of the pituitary gland that control the ovaries and altered brain processes. It has been observed that women suffering from PMS have higher blood levels of pro-inflammatory cytokines, including IL-2, IL-4, IL-10 and IL-12. It is known that brain inflammation may lead to mood swings, depression, and oxidative stress in the neurons caused by free radicals.
Scientists have also found pro-inflammatory cytokines in the ovaries and the endometrium, which can cause pain before and after menstruation. Also, there are signs of anomalies of the calcium metabolism, which may also lead to inflammation, oxidative stress, and physical and emotional symptoms. This is associated with lower total antioxidant capacity (TAC) in PMS sufferers. It turns out that vitamin D can regulate several of these processes.
Vitamin D is considered a steroid hormone with many functions
Vitamin D is considered a steroid hormone, which is because we synthesize most of our vitamin D from cholesterol, and cholesterol is the main component of other steroid hormones such as cortisol, progesterone, estrogen, and testosterone.
Most cells in the body have vitamin D receptors (VDR) that are involved in regulating various genes and a variety of biochemical processes in the body, some of which are linked to the menstrual cycle and female fertility.
PMS sufferers appear to have lower serum levels of vitamin D during the luteal phase (the period between ovulation and menstrual period) compared with women that do not suffer from PMS. Also, scientists have noted that moderate vitamin D intake (18 micrograms/day) can relieve PMS symptoms by 41 percent in comparison with low intake levels of the nutrient (3 micrograms/day).
Vitamin D’s antioxidant properties were shown in 1993, when scientists demonstrated its ability to inhibit iron-dependent lipid peroxidation. In other words, this means that iron helps catalyze free radicals, and they are particularly dangerous when they attack lipids in the cell membranes.
Vitamin D’s ability to inhibit inflammation has other antioxidant properties, as inflammation in itself creates free radicals. Therefore, the researchers wanted to look closer at the relation between vitamin D deficiency, PMS, inflammation markers, and the body’s antioxidant capacity.
PMS sufferers were given high doses of vitamin D
The sun is our main source of vitamin D. We synthesize the vitamin from a cholesterol precursor in our skin. Because modern humans spend far too much time indoors, there is a widespread problem with vitamin D deficiency, even in sunny countries.
The new Iranian study included 38 female students with PMS with vitamin D deficiency. Twenty of the women got a high-dosed vitamin D supplement (50,000 IU = 1,250 micrograms/day) once every other week, while the remaining 18 got placebo.
Just to put things into perspective, the normal recommendation for vitamin D (in a country like Denmark) is five micrograms per day, and EFSA (the European Food Safety Authority) has set the safe upper intake level at 100 micrograms per day. Because vitamin D is stored in the liver, taking 1,250 micrograms once every 14th day is the same as taking 89 micrograms daily (1,250 divided by 14). All participants did in fact tolerate the daily dose very well. Therefore, you can easily take 80-100 micrograms every single day and still be within the safety of the EFSA limit.
Vitamin D relieves PMS by way of various mechanisms
In the course of the four-month study, the severity of the participants’ PMS was assessed. Also, several blood tests were drawn to determine blood levels of vitamin D, inflammation markers, and the body’s antioxidant capacity.
The study showed the following:
- High-dosed vitamin D supplementation increased the participants’ blood levels of the nutrient, raising them to normal values
- This had a pronounced effect on several inflammation markers (IL-10 and IL-12)
- The body’s total antioxidant capacity (TAC) was improved
- The PMS symptom score was reduced significantly among the participants
- The scientists observed the exact opposite in the placebo group
The Iranian researchers also address vitamin D’s anti-inflammatory properties and that the brain is especially vulnerable to inflammation, which can cause mood swings and depression. Their study is published in Scientific Reports.
Vitamin D supplements and activation of the nutrient
As mentioned above, the sun is our main source of vitamin D. However, at our latitudes we are only able to synthesize the vitamin during the summer period where the sun sits sufficiently high in the sky for this process to take place. Spending too much time indoors and overusing sunscreen is a limiting factor as it causes many people to be vitamin D-deficient all year round. In addition, there other factors that increase the need for vitamin D such as having dark skin, being overweight, having chronic disease, and using cholesterol-lowering statins.
High-dosed vitamin D supplements containing as much as 20-80 micrograms are available on the market. Vitamin D is a lipid-soluble vitamin, which means we utilize it the best in supplement form in capsules where the nutrient is contained in oil.
It takes magnesium to activate vitamin D
The form of vitamin D that we synthesize from sunlight or take as supplements is a vitamin D precursor called cholecalciferol. It is not biologically active. In the liver, cholecalciferol is converted into 25-hydroxyvitamin D with help from magnesium-containing enzymes. This is the form of vitamin D that is measured in blood tests. When the body needs vitamin D, it converts 25-hydroxyvitamin D into its active form called 1,25-dihydroxyvitamin D with help from some other magnesium-containing enzymes. Therefore, if you suffer from PMS, you should make sure to get enough magnesium from your diet or from a supplement. Incidentally, other studies show that magnesium supplementation (360 mg/day) is able to relieve PMS symptoms.
Magnesium supplements must be absorbed in the small intestine
Any magnesium supplement should be high quality and contain bioavailable (organic) magnesium compounds. If a supplement passes right through the intestinal system, it will not have any effect. You can conduct a little test of your own by dropping a magnesium tablet into a glass of water to see how fast it dissolves. If it dissolves fast you can rest assured that body will be able to absorb the magnesium in the small intestine. Magnesium oxide that is found in many supplements and in laxatives like Magnesia has poor absorption, and this type of magnesium primarily has a local effect in the intestine.
Hajar Heidari et al. Vitamin D Supplementation for Premenstrual Syndrome-Related inflammation and antioxidant markers in students with vitamin D deficient: a randomized trial. Scientific Reports. 17 October 2019
Anne Marie Uwitonze, Mohammed S Razzaque. Role of magnesium in Vitamin D Activation and Function. The Journal of the American Osteopathic Association. 2018
American Osteopathic Association. Low magnesium levels make D-vitamin ineffective. ScienceDaily. 2018
Facchinetti F et al. Oral magnesium successfully relieves premenstrual mood changes. Obstet Gynecol. 1991
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