June 26th, 2015

Menopause & Anxiety

Hormonal changes can create imbalances in brain chemicals, leading to anxiety and depression. Discover herbal options that ease tension naturally

postmenopausal-women_1Although hot flashes grab most of the attention when it comes to menopause, anxiety is an equally common symptom among menopausal-age women. And overall, anxiety is twice as common in women as in men. During menopause (as well as the time leading up to it), hormonal changes can set the stage for anxiety.

The Anti-Anxiety Diet

Two of the most important things you can do to alleviate anxiety is to increase your consumption of plant foods—especially those high in phytoestrogens—and reduce your consumption of animal foods.

Phytoestrogens are plant substances that bind to estrogen receptors in mammals. Soy foods and flax seeds are rich in phytoestrogens, but they’re also found in other legumes, as well as apples, carrots, fennel, celery, and parsley. A diet high in phytoestrogens is thought to explain why menopausal symptoms, including anxiety, appear to occur less frequently in cultures that consume a predominantly plant-based diet. In addition, such a diet is promising for disease prevention, with some research showing a lower incidence of breast cancer and heart disease in women consuming high-phytoestrogen diets.

Increased lactic acid levels may be a factor in many cases of anxiety. There are at least six nutritional factors that may be responsible for elevated lactic acid levels: alcohol, caffeine, sugar, B-vitamin deficiency, calcium or magnesium deficiency, and food allergens. By avoiding alcohol, caffeine, sugar, and food allergens, people with anxiety can go a long way toward relieving symptoms. In fact, something as simple as eliminating coffee can result in complete relief from anxiety symptoms.

It’s also important to note that a full-spectrum, high-quality multivitamin is essential, regardless of how healthy you eat. Take consistently for best results.

Fish Oils

Fish oils high in the omega-3 fatty acids EPA and DHA have shown positive effects for patients with many different types of psychological disorders, including anxiety, depression, bipolar disorder, borderline personality disorder, and attention deficit disorder with hyperactivity (ADHD).

Fish oil trials in menopausal women showed particularly interesting results. In a 2009 study conducted in Quebec, Canada, 120 women going through menopause were given either a fish oil supplement providing 1,200 mg of EPA and DHA or a placebo for two months. The baseline level of hot flashes was an average of 2.8 per day. After 8 weeks, hot flash frequency decreased by 55 percent in the EPA and DHA group, but by only 25 percent in the placebo group.

Botanical Medicines

Black cohosh is the most studied herbal alternative for menopause symptoms. Research indicates that it is most effective for hot flashes, mood swings, sleep disorders, and body aches. It also appears to be helpful in reducing anxiety, as well as symptoms of anxiety such as heart palpitations. Some studies have used black cohosh in combination with St. John’s wort, red clover, soy, and/or chaste tree berry.

Motherwort, a traditional herbal remedy for heart and nerve health, is another option for anxiety, particularly for those whose chief anxiety symptoms include palpitations and a pounding heart.

As most people familiar with herbal medicine know, St. John’s wort is known for its benefits for mild to moderate depression. But scientists have also evaluated its effects on menopausal symptoms. These studies have not only shown that St. John’s wort can improve mood, but that it also reduces hot flashes. In regard to improving mood, the effects were most obvious after 2 months of treatment (at 900 mg per day). Women in the St. John’s wort group reported improvements in psychological symptoms linked to menopause, significantly better quality of life scores, and fewer sleep problems.

Another botanical medicine that can be of great benefit in relieving anxiety during menopause is maca. Research indicates that unlike hormone replacement therapy (HRT), maca helps increase the body’s production of estrogen and lower levels of cortisol. It has been suggested that maca’s therapeutic actions rely on plant sterols stimulating the hypothalamus, pituitary, adrenal, and ovarian glands, and therefore also affecting the thyroid and pineal glands—thus improving sleep, mood, energy, and hot flashes.

In a 4-month study, patients were given a placebo or two 500 mg capsules of maca twice daily (for a total of 2 grams of maca per day). After 2 months, maca stimulated estrogen production, suppressed cortisol, and alleviated menopausal symptoms including hot flashes, insomnia, depression, and nervousness.

June 23rd, 2015

Vitamin D3 is Important in Autoimmune Disorders

Vitamin D3 BenefitsIntroduction

Vitamin D has a well-established role in calcium metabolism and bone health, but recently there has been a great deal of research looking at the effect of vitamin D on other body tissues, especially immune cells. It is now known that there are vitamin D receptors (VDRs) located in the nuclei of all immune cells, including antigen-presenting cells, natural killer cells, and B and T lymphocytes. There is also a considerable amount of research showing that vitamin D deficiency has been associated with several autoimmune diseases including multiple sclerosis, rheumatoid arthritis, type 1 diabetes mellitus, and systemic lupus erythematosus (SLE).

A new study conducted at Monash University in Australia has now shown that low vitamin D3 status in SLE was associated with higher disease activity while an increase in serum vitamin D3 levels reduced SLE activity. This study provides hope that many patients with SLE and other autoimmune disorders may benefit from vitamin D3 supplementation.

Background Data:

Patients with SLE are prone to vitamin D deficiency. Several factors contribute to this situation including avoidance of sunshine due to photosensitivity, the use of sun-screen, and the use of medications such as prednisone and antimalarial drugs that enhance the clearance of vitamin D. Several recent studies have identified a possible association of low vitamin D3 levels and disease activity in SLE.

SLE is a chronic multisystem inflammatory autoimmune disease that is characterized by abnormalities in the functioning of several types of white blood cells that ultimately result in the production of antibodies that attack the body’s own tissues. There is increasing evidence that vitamin D can prevent or reduce many of these events.

There have been a few studies looking at the impact of vitamin D3 supplementation in SLE. In one study, patients given 2,000 IU/day showed significant reduction in the levels of pro-inflammatory markers and disease activity scores compared with the placebo group.

New Data:

The objectives of the study were (1) to determine the prevalence of vitamin D deficiency in patients of the Monash Medical Centre Lupus Clinic in Melbourne, Australia; (2) to determine the relationship between disease activity and vitamin D deficiency in these patients; and (3) to determine whether vitamin D3 supplementation is associated with increases in vitamin D3 and whether this in turn is associated with reduced disease activity.

During 2007-2013, data was collected on 119 consecutive patients. Vitamin D3 deficiency (<40 nmol/L) was detected in 27.7% of patients at baseline while 44.5% of patients were taking a vitamin D3 supplement. Patients were also assessed at baseline for inflammatory markers such as ESR, C-reactive protein (CRP), anti-double-stranded DNA antibodies, as well as renal function and complement levels to establish their SLE disease activity (SLEDAI-2K). Detailed analysis showed a significant inverse correlation of with baseline vitamin D3 level and with vitamin D3 supplementation.

Over a 12-month period of observation, among the 119 patients, there were 464 serial vitamin D3 measurements with corresponding SLEDAI-2K, representing 266 time intervals. The results showed that low vitamin D3 was not only associated with a higher disease activity, but that an increase in serum vitamin D3 levels was associated with reduced disease activity over time.

Commentary:

A large proportion of the patients were receiving vitamin D supplementation, but the dosage level was not mentioned in the study. Instead, the focus was on blood levels of D3 and the effect on SLE disease activity. From the data it appears that increasing the level to above 60 nmol/L is critical. But, unfortunately the study did not provide guidelines on what might be an optimal range for serum levels of D3. Based upon existing data, my recommendation is to hit a target range of 150 to 200 nmol/L (60-80 ng/ml). Certainly, the minimum daily dosage for someone with SLE is 2,000 IU D3 daily, but likely higher dosages (e.g., 5,000 IU daily) are likely required to hit the target range. Periodic blood measurements of D3 will allow for proper dosage recommendations.

Reference:

Yap KS, Northcott M, Hoi AB, Morand EF, Nikpour M. Association of low vitamin D with high disease activity in an Australian systemic lupus erythematosus cohort. Lupus Sci Med. 2015 Apr 8;2(1):e000064.

Dr. Michael Murray
6/23/15