For PMS, taking vitamins B5 and B6 reduces breast tenderness, helps mood changes, and eases bloating. Since the 1970s, close to twenty double-blind studies have conclusively demonstrated its benefit offering up to 84% of patients studied relief from those symptoms. An extensive 10-year study followed more than 116,000 U.S. registered nurses and concluded in 2011 that the B-vitamins are required to synthesize neurotransmitters that, if deficient, are potentially involved in the pathophysiology of PMS.1
Most B-vitamins are not stored in the body, so they must be consumed each day in food to maintain optimal health, except for vitamin B12. Although each B vitamin is chemically distinct, they work synergistically in various biochemical functions throughout the body.
Vitamin B5, pantothenic acid, is an essential nutrient, which the body cannot make and is known to be helpful in multiple metabolic processes that can relate to symptoms of PMS in patients with a deficiency. B5 is necessary for the production of all sex hormones, including estrogen and progesterone. It has a key role in the production of neurotransmitters including acetylcholine, in producing cholesterol for cell membranes, and for hormone synthesis. Pantothenic acid is required for detoxification processes in the liver to occur, for adrenal hormone synthesis, and coping with stress. Pantothenic acid is fundamental for the body’s production of coenzyme A (CoA) and acyl carrier protein (ACP) which have crucial roles in the manufacture of adrenal cortex hormones and red blood cells, and for burning carbohydrates and fats for energy.
Vitamin B6, pyridoxine, occurs in the body as the active form pyridoxal 5’-phosphate (P5P) and is similarly necessary for multiple metabolic processes within the body. Depletion of vitamin B6 can lead to symptoms of PMS. Vitamin B6 is essential for hormone balance, energy release from carbohydrate breakdown, and immune function. It specifically helps with detoxification of estrogen, progesterone, and testosterone, so a deficiency can lead to these hormones becoming unbalanced. Pyridoxine is critical for the production of proteins and other structural molecules; for neurotransmitters and formation of the myelin sheath that wraps around nerve fibers; and for synthesis of hemoglobin, red blood cells, and anti-inflammatory prostaglandins. B6, similarly to B5, is necessary for detoxification processes of the liver which assists in lowering inflammation levels and improved hormone function. B6 is also needed for serotonin production which, when low, has been linked to worsened PMS.
While long supported clinically, there is also scientific evidence for taking vitamin B6 for PMS. One study showed that taking B6 levels of at least 50mg daily, possibly enhanced by magnesium 200mg daily, seemed to relieve PMS-related anxiety and other symptoms2 Our patients see positive results for PMS with daily doses of vitamin B5 200-250mg. along with vitamin B6 25-30mg. including 2-4mg. of pyridoxal 5’-phosphate.
Recommendations:
Vitamin B5 200-250mg along with vitamin B6 25-30mg, including 2-4mg of pyridoxal 5’-phosphate, daily with meals, or as directed by your healthcare provider.
References
- Chocano-Bedoya PO, Manson JE, Hankinson SE, et al. Dietary B vitamin intake and incident premenstrual syndrome. The American Journal of Clinical Nutrition. 2011;93(5):1080-1086.
- De Souza MC, Walker AF, Robinson PA, Bolland K. A synergistic effect of a daily supplement for 1 month of 200 mg magnesium plus 50 mg vitamin B6 for the relief of anxiety-related premenstrual symptoms: a randomized, double-blind, crossover study. J Womens Health Gend Based Med 2000;9:131-9.
- Ryu A, Kim TH. Premenstrual syndrome: A mini review. Maturitas. 2015 Dec;82(4):436-40. Epub 2015 Aug 28.
- Whelan, A. M., Jurgens, T. M., and Naylor, H. Herbs, vitamins and minerals in the treatment of premenstrual syndrome: a systematic review. Can.J.Clin.Pharmacol. 2009;16(3):e407-e429.