Herbal Health

‘The worst case of endometriosis I have ever seen’. These were the first words I remember hearing through the haze after an anaesthetic.

I tried repeating the word to myself — ENDOMETRIOSIS. I drifted back to sleep, happy that at last a name had been given to the cause of my debilitating period pain.

The doctor’s voice roused me once again: ‘You’ll probably never have children’.

I wondered who the doctor was talking to. I knew it was not me because I had not even tried to get pregnant.

The truth dawned the next day when once again the doctor described the severity of the endometriosis and repeated that pregnancy looked very doubtful.

He told me that I was to take 400 milligrams of Danazol a day for three months and then he would perform major surgery including the removal of my diseased ovary.

As the endometriosis was so extensive, he felt the Danazol would only marginally improve my condition and he could not guarantee the success of surgery.

I was devastated. One day I was in hospital with a suspected ovarian cyst. The next I was told I had a disease that I could not even pronounce, I had to take male hormones, I had little prospect of ever having a baby and I was to have major surgery in the near future.

I knew very little about Danazol as it was then a relatively new drug in Australia and I asked my doctor about any side effects. He tried to assure me that I need not worry about little details and that he would look after me. I did not feel at all reassured.

The week after being diagnosed as having endometriosis, my husband’s firm transferred him interstate. I was in turmoil, life was caving in around me.

Once settled in our new home, I decided to seek a second opinion. The news about the endometriosis had been so shattering I did not want to believe it. I wanted to hear something positive, something encouraging.

My new doctor had received a letter from my first doctor giving details of the disease. The new doctor asked me if I had any questions. Did I have any questions!

For the next half an hour he quietly explained in detail all I wanted to know, including drawing some diagrams so that I understood more clearly. He felt it was essential that I knew all the possible side effects of Danazol.

After I had exhausted my list of questions, he told me that he wanted to change the dosage of my treatment. I was to increase the dosage of Danazol to 600 milligrams daily and take it for six months. He hoped he would not have to perform major surgery. At the end of six months I had a laparoscopy to see how effective the Danazol had been. Much to my doctor’s surprise there was no visible endometriosis. There were certainly signs where the disease had been, but everything appeared normal.

My doctor suggested I continue taking Danazol for another three months just to make absolutely sure the endometriosis had been completely eradicated.

A few weeks after finishing the Danazol tablets I discovered to my delight that I was pregnant.

I often wonder how my story would have ended if I had not decided to have a second opinion. Would the smaller dosage of Danazol have cleared my endometriosis? Would the major surgery have eradicated the endometriosis? Would I have been left with painful adhesions? Would I have lost an ovary? Would I ever have become pregnant?

Of course, I do not know the answers to these questions but I am grateful I decided to seek a second opinion as the outcome was more than I ever hoped for.

*117\83\2*

GnRH agonists, also known as LHRH agonists, are a group of drugs that have been developed over the last two decades. Since the mid 1980s they have been used in clinical trials in Australia and overseas for the treatment of endometriosis. They have also been used to treat a range of other conditions including anovulation (absence of ovulation) and fibroids.

The GnRH agonists are modified versions of a naturally occurring hormone, gonadotropin releasing hormone (usually abbreviated to GnRH), which helps to control the menstrual cycle.

Initially, it was drought that the GnRH agonists would not be suitable for the treatment of endometriosis as it was assumed that they would stimulate the production of oestrogen. However, it was discovered that prolonged use of the GnRH agonists actually suppressed the production of oestrogen and caused the oestrogen levels in most women to decrease to the levels found in women following the menopause. Consequently, researchers began to investigate their use for the treatment of endometriosis.

How GnRH agonists work

The GnRH agonists eradicate endometrial implants by suppressing ovulation and oestrogen secretion. The resulting low levels of oestrogen in the body mean that the endometrial implants are no longer stimulated to grow and breakdown each month so they gradually degenerate and waste away.

Most women stop ovulating and menstruating during treatment and resume ovulation and menstruation again within one to two months of completing their treatment.

Dosages of GnRH agonists generally used

Since 1971 more than 2,000 GnRH agonists have been developed by various pharmaceutical companies. Some of them are still being developed and tested while others have been released for use in some countries. At present none of them are available in Australia for the treatment of endometriosis, except under special circumstances.

Some of the more well known GnRH agonists are Buserelin (Superfact), Naferelin (Synarel), Leuprolide (Lupron), and Goserelin (Zoladex).

None of the current GnRH agonists are effective when taken by mouth because they are broken down in the digestive system. Other methods of administering the drugs have been developed, including nasal sprays, daily injections and monthly injections.

Side effects GnRH agonists

The side effects experienced by most women are usually a result of low oestrogen levels. The majority of women experience hot flushes and some also experience other menopausal-type symptoms, including vaginal dryness, decreased libido, headaches and depression. The side effects usually disappear soon after the cessation of treatment.

The GnRH agonists appear to have no adverse effects on the levels of fats and cholesterol in the blood.

One possible long-term side effect of GnRH agonist therapy is osteoporosis (loss of bone density). In trials conducted so far some women have shown a decrease in the density of the bones in their spines; it appears that this effect is reversed and the bone density usually returns to normal within six months of ceasing treatment.

At present it seems that this loss of bone density is not likely to be a significant long-term problem if the treatment lasts only six to nine months but considerable further research is needed before the complete picture is known.

How effective are the GnRH agonists

The results of the clinical trials indicate that the GnRH agonists are effective in eradicating endometriosis and relieving its symptoms but, like all the other hormonal drugs, they have no significant effect on adhesions or endometriomas and they are not a permanent cure. Overall, the GnRH agonists appear to be as effective as Danazol. When they have been approved for use in Australia they will probably assume an important place in the hormonal treatment of endometriosis.

*60\83\2*

The female reproductive organs consist of the uterus, fallopian, tubes, ovaries, cervix, vagina, vulva, clitoris and labia.

Uterus (womb)-The uterus is a hollow muscular organ which is about the size and shape of a flattened pear. It lies between the bladder and the lower end of the bowel and is approximately 7.5 centimetres in length and weighs about 40 grams.

The upper part of the uterus can move forwards and backwards to some degree within the pelvis. Usually, it is tilted forwards so that it lies against the back of the bladder. In this position it is said to be anteverted. However, it may be tilted backwards and when it lies in this position it is said to be retroverted.

The uterus is made up of three layers. The outer layer is known as the peritoneum. The middle layer consists of a thick layer of muscle known as the myometrium. The inner layer which forms the lining is known as the endometrium. When this endometrium is found outside the uterus it is known as endometriosis.

The main function of the uterus is to protect and nourish the growing foetus during pregnancy.

*1\83\2*

This ancient Japanese therapy uses pressure and vigorous massage to stimulate the flow of energy through the body. Like its Chinese equivalent, acupressure, Shiatsu requires no needles, relying instead on the thumbs, palms and heels of the hands, elbows, knees and feet to apply and sustain pressure on vital points all over the body.

It is particularly effective for pain relief and its advocates claim that by making the flow of energy through the meridians more efficient, Shiatsu is a highly effective preventive therapy which strengthens the nervous, circulatory and immune systems and invigorates the body.

In a variation sometimes known as barefoot Shiatsu, the therapist often uses the feet to apply pressure, sometimes standing on the patient. Even so, thumbs, elbows and hands are still employed.

The great advantage of Shiatsu over similar therapies such as acupuncture is that it can be practised in the home for the relief of simple ailments such as headache, insomnia, cold symptoms, constipation and nausea. Some formal instruction is recommended and professionally qualified practitioners should be used for diagnostic purposes and in cases of chronic or prolonged illness.

*47\69\2*

As I have noted, insomnia is one of the most commonly reported disturbances in behaviour. As the above table indicates, as many as one in three people reports that in the previous month there has been some problem related to sleep patterns. Many people have written to tell me that they have taken St John’s Wort to treat their insomnia and to good effect. For example, a 52-year-old woman began to take St John’s Wort ‘because I was not sleeping when it was possible to do so’. Since starting St John’s Wort T don’t stay awake if I wake up during the night unless there is an emergency. It also reinforces my positive outlook during the day’

Although there are no studies of the effects of St John’s Wort for insomnia, it is important to remember that sleep difficulties are a cardinal symptom of depression. These difficulties may take the form of having trouble falling asleep, tossing and turning or sleeping fitfully during the night, or waking up too early in the morning. So distressing are such symptoms that they may overwhelm the clinical picture and the depressed person may misdiagnose the condition as insomnia.

All types of anti-depressants may be helpful in reversing insomnia when it is part of the overall picture of depression. St John’s Wort is no exception in this regard. People with insomnia might benefit from reading over the symptoms of depression to determine whether they are suffering from other symptoms of depression as well. If they are, then the herbal remedy is more likely to help resolve their sleep difficulties.

A 56-year-old woman writes to tell me how her sleep difficulties, which were the most troublesome symptoms of her depression, were helped by St John’s Wort: ‘I can sleep again!‘ she exclaims. ‘Getting rest at night has helped everything else; gloom has lifted and I am in good spirits, energetic and positive. I feel a heavy weight off me. Immediately (the first night) I began to have dreams. I used to dream lots until about five to six years ago when the menopause kicked in. I did not dream as usual, if at all. I really hadn’t thought about it until I took St John’s Wort and began to dream again. Maybe the increased dreams are also related to my increased sense of well-being.’

If there are no other symptoms of depression, however, the insomnia may well be due to some other condition. It is worth paying a visit to your GP to have the problem checked out, as some causes of insomnia are potentially dangerous and eminently treatable. One such cause is sleep apnoea, a condition in which people stop breathing for brief spells frequently during the night, which wakes them up repeatedly. This leaves people drowsy and feeling ‘hung over’ during the day, and puts them at risk when driving or operating machinery. The resulting lack of oxygen to the tissues can also be medically harmful. Sleep apnoea is unlikely to respond to St John’s Wort, but can readily be treated by other means, such as a special machine that pumps air into the lungs when the person stops breathing.

Simple but important factors worth considering in identifying possible causes of insomnia include commonly used drugs, such as caffeine, nicotine and alcohol. Often cutting down the number of cups of coffee, tea or caffeinated sodas, particularly in the latter part of the day, can work wonders in bringing insomnia under control. Some people may not realize that nicotine is a stimulant and that smoking in the latter part of the night may be preventing them from falling asleep. Even though alcohol has immediate sedative properties, its effects wear off after a few hours. So too much alcohol at night may appear to promote sleep but may actually disrupt it when blood alcohol levels begin to fall. Removing these drugs from the latter part of the day or, at times, altogether, can be very helpful in promoting restful sleep. In addition, sleep experts emphasize the importance of what they call sleep hygiene – a quiet peaceful bedroom with dim lights and low noise levels. They recommend keeping arguments and conflicts out of the bedroom and engaging in peaceful rituals to wind oneself down before bedtime. If such simple remedies don’t help overcome sleep difficulties in the absence of depressive symptoms, it is worth seeking out the help of an appropriate doctor. If insomnia is part of a depression, however, it may resolve when treated with St John’s Wort or an anti-depressant.

*22\75\2*

Patricia Engel was a skilled pianist and violinist, thirty years of age, who had been well until moving into an all gas-equipped house. At the same time she had changed most of her wardrobe from natural to synthetic fabrics. Within a four-to-five-month period she noticed that she needed rest periods during the day. She also suffered from increasing levels of morning fatigue. Soon this was followed by unexplained muscle soreness.

Miss Engel took a trip to Europe. After being exposed to excessive amounts of motor exhaust while traveling, however, she developed chills and arthritic pains of the neck and shoulders. Another similar episode occurred after she disembarked in New York City when she ran into heavy traffic fumes. But two weeks after returning to her apartment, with its gas-fired range and water heater, generalized joint and muscle aching and pain incapacitated her. The pain started in her shoulders and spine and then spread rapidly to her fingers, hips, knees, ankles, and other joints.

Conventionally minded doctors treated her with aspirin and another nonaspirin pain-killer. Soon she was given cortisone therapy. After three years of this, however, she developed a cataract, whereupon the drug was discontinued. She also received indomethacin (Indocin) and gold therapy, an experimental form of arthritis treatment. Nothing stopped the spread of the disease. By this point, she was so crippled that she had to abandon her career as a musician, since she could no longer play the piano or violin.

Upon admission to the hospital under my care, she fasted and suffered headaches and muscle and joint pains as withdrawal symptoms. These symptoms soon cleared, and her joint movement increased. Miss Engel was then tested with chemically less contaminated health foods. Her reactions, listed in the order of their rapidity of onset, were as follows:

Corn: 30 minutes, sleepiness; 1 hour, restlessness; 3 hours, fatigue and sensitive joints, with generalized myalgia and arthralgia the following morning

Tomato: 30 minutes, knees, hands, and wrists more tight

Peas: 30 minutes, arms, shoulders, and fingers tightened and more sensitive

Beets and beet sugar: 1 hour, restless legs and increasing generalized stiffness

Lamb: 2 hours, hoarseness, followed by chilling and progressive fatigue

and arthritic pains

Rice: 2 hours, tightness and stiffness of knees and wrists

Wheat: 4 hours, restless legs with residual muscle and joint stiffness

Milk: 4 hours, stiffness of joints with residual generalized joint stiffness

and soreness

Beef: 8 hours, aching joints with residual pain in joints

When Miss Engel was fed regular supermarket foods, which had been tolerated in their organic form, after the third such meal she awoke during the night with extreme stiffness and chills, all her joints being so sore that she had to be helped out of bed.

Upon returning home, she avoided all of her incriminated foods, and chlorinated water, and by following the Rotary Diversified Diet (Chap. 18), she remained well. Within a week, however, her arthritis gradually returned. This was tremendously disappointing, especially since she had previously removed her gas stove. She did notice, however, that she felt better when she was outside the house and became increasingly worse the more time she spent inside.

She therefore had her gas-fired heating system removed and replaced it with electric heaters and also had the gas pipes removed from the walls. She made her bedroom into a pollution-free “oasis” (Chap. 20) and then reintroduced questionable items one at a time. She was found to be susceptible to polyester bedsheets, living-room curtains, and several other plastic and synthetic materials. The finish on the doors of her kitchen cabinets was suspected, and there was definite improvement when it was removed.

At the present time, Miss Engel is free of muscle and joint pain, but there remains some impaired motion in the left wrist, due to the destruction of tissue caused when her illness was uncontrolled. She also gets a mild increase in arthritic symptoms before her monthly period, after housekeeping, when the pine trees in her yard are putting out new growth, and when she is working in the yard. However, there is simply no comparison between the minor problems which she has now and the crippled patient whom we admitted to the hospital a few years ago.

Patricia Engel is just the sort of patient whose case could not have been fully understood in the 1940s or early 1950s, because much of her illness was caused by chemical susceptibility. Even such a seemingly innocuous material as the varnish on her kitchen cabinets was contributing to her arthritis and had to be modified or removed before she could get significantly better.

Few diseases are as pathetic as rheumatoid arthritis in children. This problem often starts innocently enough as a swelling in a knuckle or finger, spreads to other parts of the body, and finally leaves the child a cripple for life. It is often accompanied by swollen lymph nodes (glands), enlarged spleen, fever, profuse sweating, and anemia. Conventional medicine recognizes no agreed-upon cause or effective treatment for this ailment.

*74\110\2*

One of the most disturbing aspects of the indoor air pollution problem is the involvement of schools. Here, the use of various chemicals can contribute to the overall chemical and food problem to cause poor performance by both children and teachers.

Poorly designed heating and cooking systems in schools are a major source of trouble. One teacher was always dopey and drowsy when he taught a class located directly above the school cafeteria, from which gas-range odors emanated. His performance improved dramatically when he transferred to a more distant room.

Children suffer all sorts of adverse reactions to chemicals in school, including hyperactivity, inattention, irritability, and the like. This is especially so among children addicted to “junk food,” who live in a polluted home environment.

In 1967, Mrs. Kathleen A. Blume carried out with my help a study of indoor air pollution at a public school in Wauconda, Illinois, a suburb of Chicago.8 Mrs. Blume, a home economics teacher, was aided by local parents who were concerned about the quality of air in their children’s schools.

They literally sniffed out problems in the schools:

We used both eyes and nose searching and sniffing our way through . . . school trying to uncover the elusive as well as glaring causes of air contamination. In spite of advances in instruments for measuring contaminating particulates in the air, the human nose remains the chief detector of offensive odors.

It is remarkable, and depressing, how many sources of air pollution these parents were able to find stored in the school. For example, aerosol sprays are known to cause problems because of their volatile mixtures of chemicals, solvents, and the propellant, Freon (itself a mixture of carbon, chlorine, and flourine). The parents found insecticide sprays; paint, enamel, and lacquer sprays; fixatives; spray snow; spray plastic; solvent cleaner; germicidal cleaners; room deodorants; hair spray; furniture polish; disinfectants; deodorants; and even fungicidal sprays for the locker room.

Francis Silver, the engineer who studied this list and cooperated in the Wauconda study, reported that none of these, with the possible exception of the spray enamel and the fixative, could be justified from an ecological point of view.

In some cases, the children were more aware of the dangers of the sprays than the adults. One child, for instance, complained of a burning sensation in her nose, eyes, and throat after a janitor sprayed a disinfectant in a room full of children. This child’s problem lasted well into the evening. When a teacher cleaned her desk top with a spray cleaner, one of the children disliked the smell so much that he asked permission to leave the room. And when another teacher sprayed fixative on chalk drawings, several children complained of the odor and asked her to open the windows.

It should be noted that such sprays not only pose a danger of provoking allergylike symptoms but can result in “spray keratitis,” or damage to the sensitive cornea of the eye from chemical particles in aerosol spray cans.7

Another source of problems in the Wauconda study was janitorial supplies. Twenty-eight different chemicals were found in the supply closets, including some highly toxic products. Mrs. Blume commented:

Janitorial supplies are probably the saddest part of the story. Janitorial chemicals receive no supervision, anything goes. We are so particular about who is allowed to prescribe drugs for patients but janitors spread their products around which then evaporate into the breathed air and are then ingested.. . . If we were more interested in health and not just in treatment, we would probably be more particular about our janitors than we are about our physicians.

The use of such products in schools often represents an “overkill” of bacteria. Dr. Malcolm Hargraves, a senior consultant at the Mayo Clinic, has said:

The American people, I am afraid, are greatly oversold by any article which makes the claim that it is medicated [i.e., anti-bacterial]. The universal use of such agents with such an idea only leads to the development of more resistant strains of bacteria to plague us in the future.8

Actually, fresh air, sunshine, hot water, and unscented soap are still the best disinfecting agents. The “progress” in inventing disinfectants of the last thirty or forty years has added little to our ability to control infectious diseases, while piling up problems for the chemically susceptible. It is tragic to expose children to these and other agents so early, creating a problem which may remain with them for the rest of their lives.

*44\110\2*

Fainting is a temporary loss of consciousness caused by the involuntary (autonomic) nervous system. It is usually due to a temporarily insufficient amount of blood in the brain. Fainting can be brought on by pain, physical fatigue, low blood sugar, a disturbing scene, sudden fright, and other strong emotions.

Fainting is common in pre-adolescent and adolescent children. It often occurs after the child has gone without eating for an extended period of time. A partial faint (light-headedness and dizziness) or a complete faint is also common when a teenager abruptly changes position (for example, after jumping up from a reclining or sitting position). It also can occur in a dentist’s chair caused by a combination of pain, anxiety, and turning the head sharply to one side (which places pressure on the carotid artery in the neck).

Just before unconsciousness, the child experiences light-headedness, blurred vision, cold and moist skin (clamminess), and sometimes mild nausea. An observer may notice a paleness or greenish color of the skin and a glazed look in the eyes before the child loses consciousness. Rarely will the child lose control of the urine or stools. Consciousness will be recovered within a few minutes and the child will probably not remember fainting.

The pulse at the wrist may be characteristically feeble and slow or not present at all. The heart beat (place your ear against child’s chest) is slow, usually 50 beats per minute or slower.

Consider the circumstances under which the child fainted. If they were circumstances that typically can cause fainting, and if the child rapidly and completely recovers, this suggests nothing more serious than an isolated spell.

*69/84/5*

Often heart disease runs in the family, and sometimes large numbers of family members die at a relatively young age of this condition. Our genes affect how high our LDL cholesterol is because they determine how fast LDL is made and removed from the blood. You are two to five times more likely to have a heart attack if a first degree relative has died of coronary heart disease before the age of 60.

There is a genetic condition called familial hypercholesterolemia (FH). It is an autosomal dominant disorder that produces severe elevations in total and LDL cholesterol. The DNA in our cells is packed into chromosomes, which occur in pairs. Autosomal comes from the word “autosome” which means all chromosomes other than the sex chromosomes. Dominant means that only one parent needs to contain the defective gene to pass it on to their offspring.

Heterozygous familial hypercholesterolemia occurs in approximately 1in 500 people worldwide, and it causes an approximate doubling in LDL cholesterol levels.

Heterozygous means that only one defective gene is present for a condition, so it usually produces a less severe case of the disease. In other words only one parent passed the condition on, rather than both parents. FH is especially common in French Canadians, Lebanese, South Africans and Ashkenazi Jews.

In FH the LDL receptors are either missing or deformed. These receptors are required in order for the liver to take up LDL that has been floating in the bloodstream, process it and remove it from the bloodstream. If the liver can’t take up LDL particles, blood levels quickly rise. Also, if LDL is not able to get into liver cells, it can’t suppress the production of more cholesterol, therefore greater amounts of cholesterol are produced, and blood levels rise. In people with heterozygous FH, only half the normal number of LDL receptors is present. Commonly, levels of LDL cholesterol will be between 5.1 and 10.3 mmol/L. In normal healthy people LDL cholesterol should be no higher than 3.5 mmol/L. People with heterozygous FH typically develop premature coronary artery disease; men typically in their forties, and women 10 to 15 years later.

Homozygous familial hypercholesterolemia is a much more severe case of the disease, as both genes are defective. It affects approximately one in one million people. In people with this condition sudden death due to a heart attack occurs as early as age 1 to 2 years.

High blood levels of LDL cholesterol in people with FH means that various cells in the body that do not require LDL receptors, take up and absorb cholesterol. This includes monocytes and macrophages, which can turn into foam cells and lead to the production of fatty plaques in the arteries.

People with familial hypercholesterolemia often display telltale signs on their bodies called xanthomas. The word xanthoma is derived from the Greek word xanthos, which means yellow. Most xanthomas have a yellowish appearance, but this isn’t always the case. They are basically deposits of fat, connective tissue and blood vessels in and under the skin which grow on various sites of the body. People with familial hypercholesterolemia typically develop xanthomas on their Achilles tendons and tendons on the hands. Sometimes a xanthoma develops on the inner side of the eyelid; this is called a xanthelasma. An iridologist looking in the iris of a person with FH will usually see an arcus senilis, this is a cloudy ring on the outer border of the iris. There are several other genetic conditions besides FH which produce severely elevated levels of LDL cholesterol.

*12/53/5*

The premenstrual syndrome is a collection of symptoms and bodily and mental changes that occur, usually regularly, anything from a few days up to two weeks before the onset of a woman’s monthly period. The problems stop with the onset of bleeding.

The syndrome has tended to appear a somewhat woolly collection of symptoms and signs (more than a hundred have been reported) and this has led many, mostly male, doctors to question its existence as a real entity. To the women who suffer from it, though, it is real enough, and although there is undoubtedly a psychological element to many cases it is by no means a problem that is ‘all in the mind’.

The most common complaints are of anxiety, nervous tension, mood swings, irritability, weight gain, breast tenderness and headaches.

Between 30 and 35 per cent of women of childbearing age suffer from it. Almost 5 per cent of women are severe sufferers and become suicidal, accident-prone or very difficult to live with when they have PMT.

Recent research has shown that there are several fairly clear-cut sub-fractions of the condition which respond to different treatments:

ÐÌÒ-Ë women complain mainly of nervous tension, anxiety, irritability and mood swings occurring as much as two weeks before the onset of their period. The symptoms get worse and are sometimes followed by mild to severe depression, improving with the onset of bleeding. These symptoms have been found to be caused by too much oestrogen-research indicates that oestrogens act as stressors to the nervous system. Progesterone, on the other hand, has a calming effect. Research shows that the liver is unable to de-activate these raised levels of oestrogens without adequate supplies of  vitamins.

PMT-C women find their appetite increases two weeks before a period and they crave sweet, sugary things. The craving is especially bad if the woman is under stress. An hour or two after eating the sugar-rich foods the woman feels low, tired and shaky. If you are under stress and eat a lot of refined sugar several things happen. Stress changes the levels of certain brain enzymes, which creates a relative deficiency of a substance called dopamine. The highly refined sugar eaten forces the amino-acid tryptophan into the brain cells where it is converted to serotonin. An excess of serotonin causes palpitation, nervous tension and drowsiness, among other things. The refined sugar triggers the release of too much insulin and this reduces blood-sugar levels. A deficiency of a hormone called prostaglandin E (PGE) may also be involved. PGE suppresses the insulin response to sugar and reduces the nervous system’s responses to a decreased blood sugar. The following nutrients are needed for the formation of PGE from cislinoleic acid, which is its dietary building block: magnesium, zinc, and vitamins B3, B6 and C. Perhaps the craving for chocolate so many PMT-C sufferers have is really for the magnesium and phenyl-ethylamine (related to dopamine) that chocolate contains.

PMT-H women mainly complain of weight gain during the last few premenstrual days. Their body weight goes up, their breasts, hands, feet, faces and ankles swell. Rings become tight, shoes and skirts are tighter than normal, contact lenses feel less comfortable or even cannot be worn, and the breasts and lower abdomen are tender. Most women in this group gain only 3 lb or less in weight but it seems to be all in sensitive places. Some gain as much as a stone.

Such women often have normal oestrogen levels but have elevated levels of hormones produced by the adrenal glands that control salt and water retention by the kidneys. High brain levels of serotonin stimulate the release of ACTH-a brain hormone that makes the kidneys retain salt and water. Excess carbohydrate consumption makes the body produce too much insulin, as we saw above, and insulin is known to make the kidneys retain more salt than they should. Stress also makes the kidneys retain salt and water.

PMT-D women have premenstrual depression, are withdrawn and confused, cry easily, can’t sleep, are forgetful, and may even be suicidal. Many such women, if they have no other signs, are not diagnosed as PMT sufferers and end up with psychiatrists. Some of these women improve with oestrogen supplements.

*7/72/5*