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March 19, 2013


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The findings of this study may be beneficial to women (and men) everywhere! Many women come into community pharmacies looking for PMS symptom relief, and are willing to try just about anything. Even if the results of this study are not as conclusive as is typically desirable, correct iron supplementation may be a reasonable option to help alleviate their symptoms.

Premenstrual syndrome is very prevalent among women. I know many women who experience the common symptoms of irritability, anxiety, bloating, fatigue and food cravings each month. This study definitely poses great potential for helping these women eliminate at least some of these symptoms. I will definitely recommend them to consume more nonheme iron such as beans, lentils, flours and grains. More research should definitely be done to ensure its efficacy because this information can potentially help many women.

I seen this first hand, one of my best friends has had Iron deficiency anemia for some time now, And one of the biggest things she noticed before she started taking iron was that her PMS symptoms had been much worse than they were before. Now that she has started taking iron supplements, and her hgb are coming back up, her fatigue, irritability and other PMS symptoms have greatly improved. But unfortunately its almost like one step forward and two steps back because the menstrual cycle can cause further iron deficiency!

I am questioning whether high iron intake is needed or adequate iron. It seems like most women are deficient in iron. Also, because there are so many other nutrients that may be making a contribution it may be beneficial to see whether there is a combination effect. Also, there is a birth control out with added iron, which seems to target women who do have heavy menstrual cycles.

I am surprised to learn that PMS is composed of more than 150 symptoms. I am curious as to what symptoms iron supplementation improves. I personally suffer from iron deficiency anemia, and although I forget to take my iron pills, this is more incentive for me to remember to take them!

Yet again another interesting study. Just wanted to point out that the article stated that the women had a 36% reduced risk of developing PMS symptoms. The investigators note that this risk is a reduction in relative risk. I always hate it when studies analyze results as "relative risk" cause oftentimes.. that number is much more impressive than absolute risk. Some studies I've read, when you look at the absolute risk, it's only like a few percentage points at most of decrease in risk.. but when you make it "RELATIVE"... suddenly that number jumps to 30% or 40%.

Sometimes when analyzing results for the clinical benefits.. I find it easier to analyze risk as an absolute risk reduction rather than a "relative risk reduction."

Wow, I did not know that there were 150 symptoms of PMS. This write up does not specifically say what symptoms of PMS it helps with. It seems like there is a connection with iron and synthesis of dopamine, norepinephrine and serotonin. Also, I would like to know what dose they used or what is considered high iron intake. I wonder how long this effect lasts because some women experience PMS at different times and when would they need to take it.

I would like to see more data on this, as the authors of the study suggested. What iron/zinc levels correspond with PMS symptom development? What happens when women who do have lower levels are supplemented or improve their diets? I would also like to see the study include more women of varying body sizes. The original excluded women with 3500/calories/day consumption, which is easily exceeded in this country.

I think anytime we talk about the benefits of a certain medication it is crucial to realize that if it is not taken correctly you may not see the benefit. With Iron there are multiple things to keep in mind. Lisa mentioned calcium and how it decreases iron absorption. What I saw a lot of in my previous rotations were patients taking Iron supplements along with their Omeprazole and their Iron levels never increased so doctors would increase their iron dose without really thinking about other things that might be in play. This is where I guess pharmacist come into the picture and patient counseling plays an important role.

I recently had problems with extreme fatigue post-menstruation that warranted a visit with my healthcare provider, and lab tests reinforced my suspicions of having low iron. Based on my levels, my doctor suggested I just make an effort to increase my intake of dietary iron and to avoid eating these foods with those containing calcium, as calcium can decrease iron absorption. It is interesting, and even counterintuitive, that many iron-containing packaged foods also contain calcium, however.

If you suspect low iron may be an issue, supplementing may not be your best immediate action. It would be best to see a physician who can prescribe the appropriate blood tests (i.e. hemoglobin testing, direct iron levels, iron-binding capacity, and iron storage tests) to assess if a deficiency is, in fact, present, and that there is not another issue going on.

It is definitely important to consider the side effects of high-dose iron. Although it is considered a "natural" therapy, iron supplementation may have adverse effects, such as intestinal discomfort, especially at higher doses. So even though women may be suffering from less PMS symptoms, they may get bloating, flatulence, and constipation in return for increasing their iron consumption.

I too am curious what the researchers mean by high iron intake. Not every patient with PMS needs to take iron supplementation; a lot of the same effects can be achieved with diet and exercise. I agree with the previous posters in that lifestyle modification is the way to go, before adding on potentially dangerous high doses of iron.

I think the comments about lifestyle are very important. As it was pointed out, people eating healthier also tend to have healthier lifestyles. So is it the extra iron or the combination of being overall healthier. Consumption of foods that are salty can also make PMS worse, but it is likely that healthier people are also eating less salty foods, so it's probably not as simple as just extra iron.

This is an interesting topic. Finding an alternative to drug therapy for treating/preventing PMS sounds great. What i'd like to know is what they mean by high-dose iron. How much iron are they talking about. What if I already eat a lot of beans, lentils, flours, cereals and grain products? Does that mean I need to eat a lot more and how much is a lot more? Do I start taking high dose iron supplements and if I do then what about all the common gastrointestinal adverse effects (constipation, nausea) and GI irritation associated with iron. LIfe stye modification is the way to go if you ask me. Exercising and not drinking alcoholic beverages works for me!

It's an interesting concept to think about - though I'm not sure how I feel about the high iron intake. It is good to hear that there may be a fairly simple treatment option for this. .I know some women, and those in their company during ‘that time’ do suffer, and would appreciate relief! I definitely think further study is warranted, as the results weren't as conclusive.

Except food cravings, PMS sounds almost like Postmenopausal Symptoms. I wonder iron supplement would help menstrual cycle related symptoms in general.

I'm curious why higher consumption of the more poorly absorbed nonheme iron was linked to reduced PMS symptoms. Maybe the high intake overcame the body's poor absorption?

One also has to consider the typical confounders. Individuals who have higher intake of vegetables and whole grains (nonheme iron sources) are typically healthier, exercise more, and more health conscious. Exercise reduces high fat deposits which are great reservoirs for estrogen and may help promote hormone imbalances that are often thought to promote or underlie PMS. It certainly seems like a vicious cycle in more ways then one!

While this is an interesting link, it is important to refer these patients to a medical professional before recommending high dose iron. Iron is definitely something that can be overdosed, and it is important that a woman interested in experimenting with high dose iron for the treatment of PMS does so under the supervision of a doctor. It also does not sound like this study was vey conclusive, as the patients who were taking high dose iron and saw a decrease in PMS symptoms could have also had a low potassium diet that could have been causing the benefit.

This study is interesting to think about. I never thought that what I eat could be effecting my PMS. At the same time it is great to think that a simple change in my diet and maybe a few vitamins and minerals and I could be suffering less every month. That is a great option when symtoms are bad and you don't want to take medication.

The abstract really isn't telling me that much - how much iron are we talking? "The highest non-heme iron intake" - is that implying two iron tablets a day supplementation (for example), or just from food intake? It's also interesting that non-heme iron intake would have made the most difference, since that is the form less well absorbed by the body . . .

It is unfortunate that this seems to be a positive feedback cycle; no pun intended. The heavier a woman's menstrual cycle, the more likely she is to become iron deficient. If this study is to be taken at face value, then it would appear that the same women with higher iron losses now also will experience worse PMS symptoms.

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