7

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Thiamine and Dysmenorrhea (Menstrual Cramps)

Answered on August 19, 2014
Created August 25, 2012 at 12:01 AM

When I first started paleo eating, I was convinced it would be the answer to my painful and annoying menstrual cramps. Much to my dismay, I have seen absolutely no improvement in this department after a year on the paleo diet. I???ve tried high dose zinc in the days leading up to my period, and I???ve tried magnesium. They worked great for my skin and sleep, but, frustratingly, not for my cramps.

I recently came across a very successful placebo-controlled trial using high dose thiamine for young women in India.

http://www.ncbi.nlm.nih.gov/pubmed/8935744

Study Summary: Out of 556 women with moderate to severe primary dysmenorrhea, 100mg of thiamine hydrochloride for 90 days completely eliminated menstrual cramps in 87% of the treatment group members and greatly reduced the pain in another 8% of the women. Apparently thiamine deficiency is quite common in the demographic of the study???s participants, so the question remains whether or not this would work in thiamine-replete individuals. But these are impressive improvements nonetheless! Also, the authors of the study suggest that the treatment might be curative since the results remained after two months of no thiamine supplementation.

I???m pretty sure I have SIBO, so I did some googling on SIBO and thiamine to see if I am perhaps not quite as thiamine-replete as I might assume. I came across the following study:

http://www.ncbi.nlm.nih.gov/pubmed/19083422

Although the study participants have all had gastric bypass, the authors seem to place most of the blame for thiamine deficiency on the ensuing change in the microflora.

Study Quote: ???21 patients (17 women and 4 men) had thiamine diphosphate levels less than the lower limit of the reference range and abnormal glucose-hydrogen breath tests, consistent with small intestinal bacterial overgrowth. Fifteen patients received oral thiamine supplements, but repeated thiamine levels remained low in all 15. Nine of these patients then received oral antibiotic therapy; repeated thiamine levels were found to be normal in all 9 patients. These results support the hypothesis that small intestinal bacterial overgrowth results from altered gut ecology and induces thiamine deficiency after gastric bypass surgery in obese patients.???

Then, just to add to my case, I couldn???t help but notice on the following paleohacks thread that thiamine intake tends to be slightly low among many people who follow a paleo diet (although it certainly doesn???t have to be ??? there are plenty of good sources such as pork and tuna).

http://paleohacks.com/questions/101231/nutrition-trackers-poll-what-are-your-top-3-and-bottom-3-micronutrients-on-the#axzz24K03qgBm

Perhaps women on the paleo diet should be paying extra attention to their thiamine intake, maybe even supplementing with thiamine temporarily and making sure they don???t have SIBO?

I think I???m going to give thiamine supplementation a try this month (in addition to my constantly evolving attempt to control my suspected SIBO), but I???d love to hear if anyone has tried this or if anyone has further thoughts on this topic.

0e84c3d1553e77af594676e971e2aa4a

on November 13, 2012
at 11:10 PM

I could not guarantee anything, but the only two women I know who needed it for PMS had good results. Must be started at the right time and continued only two weeks per cycle then discontinued two weeks. The products might differ in concentration and absorption. I could tell you what brand XGF used but two months ago she said she could not get it in Europe easily so I sent her the two different tubes she left here the year before. I think one was NOW brand and the other was from LEF. "Correct the spice" as they say in cooking, titrate to get the result, but within a range no risk to try higher

Ce41c230e8c2a4295db31aec3ef4b2ab

(32566)

on November 13, 2012
at 03:28 PM

Progesterone cream.

Ce41c230e8c2a4295db31aec3ef4b2ab

(32566)

on November 13, 2012
at 03:27 PM

Tried it for many months & no effect on my cramping. I usd Pro-gets cream. I get that cramping happens for different reasons for different women, so there isn't a solution that will work for everyone.

Ff5307d657eb7bbcc526dc7cf1ddd7fd

(460)

on October 20, 2012
at 03:51 PM

Thanks for your input, RyanMT. I agree high doses of vitamins can be problematic - in fact, I haven't tried the thiamine protocol yet because I am worried about this. I just wanted to throw it out there and see if anyone has tried it. Thiamine seems to be quite safe, but I don't get the feeling that supplementation has been studied extensively or in the long term. Although, I guess the question also becomes, is it likely safer than the alternative, which for me is doping up on NSAIDs two or three days each month? I don't have the answer for this, unfortunately.

8634d4988ced45a68e2a79e69cc01835

(1617)

on October 11, 2012
at 09:27 PM

Right. B6 toxicity is no joke! And so many multivitamins have loads of it!

Ce41c230e8c2a4295db31aec3ef4b2ab

(32566)

on August 26, 2012
at 01:10 AM

Sorry, I was referring to previous posts on the general topic of cramping, not thiamine supplementation. Thanks for your question!

Ff5307d657eb7bbcc526dc7cf1ddd7fd

(460)

on August 25, 2012
at 01:03 PM

I think this is a good start for many people. However, an extremely clean paleo diet can still be quite problematic for someone with SIBO. I had been gluten-free for several months before going paleo, and while going gluten-free had a very positive effect on my digestion, going paleo at that point had a negative effect on my digestion. A kind of combined paleo and FODMAP approach works much better for me. Since I suspect SIBO could be related to dysmenorrhea, I think this is worth noting.

Ff5307d657eb7bbcc526dc7cf1ddd7fd

(460)

on August 25, 2012
at 12:57 PM

Dragonfly, could you link to where thiamine has been discussed in relation to menstrual cramps? I thought I had scoured the available discussions on menstrual cramps, and I have tried many of the suggestions. That's why this particular study caught my interest - I have not seen this particular protocol discussed.

Ce41c230e8c2a4295db31aec3ef4b2ab

(32566)

on August 25, 2012
at 12:57 AM

Do a search for menstrual cramps/cramping & you will find several questions on the topic.

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10 Answers

1
44be8f11e2826a644baa6bdec39c68b2

on November 26, 2012
at 03:49 PM

Anecdotal, but a slow-release Vitamin B Complex (I take Trader Joe's) taken everyday (i.e. all month) has meant the difference between debilitating cramps and a normal period for me.

1
Ce41c230e8c2a4295db31aec3ef4b2ab

(32566)

on August 26, 2012
at 01:16 AM

I supplement regularly with a multi-B vitamin (NOW brand B-50) & have not noticed any reduction in my cramping. I may try 100 mg thiamine alone, per the study and see what happens.

Don't know about SIBO, but I do have FODMAPS-intolerance, so gut dysbiosis is def an issue for me.

Will be interested to hear your update!

0
0f8bdc2e0d562595fe1661612332d1ce

on February 04, 2013
at 04:12 AM

Magnesium and fish oil have been the answer for me. Now I am able to completely avoid 2 days worth of NSAIDS every month. They used to hurt my stomach and may have made my gut issues worse (I have fructose malabsorption).

But it was not just any old magnesium, it was high doses of magnesium glycinate and the fish oils have to be taken every day consistently.

Annoyingly though, I am now having issues with calf cramps and wonder if I am taking too much magnesium. I'm loath to take less though since it helps so much with my stiff neck and stress levels...

0
0e1e1fb7cb5ba898eed1976f988cdc37

on December 10, 2012
at 03:53 AM

I use to have this problem too. My doctor said i had dysmenorrhea and I used to take 3 ibuprofen every 3 hours the entire week. At one point I was on prescription meds for cramps. Since eating paleo I no longer have to take any meds. The decrease in inflammation is likely the reason. I still have them slightly but nothing like before. I do notice that eating even just a little off paleo will make them worse. Try to eat strict the few weeks before and see if it helps. I have also found the heat pads that have sticky and attach to your underwear work great also. They can be found in a drug store by the back patches. There is one specifically for menstraul cramps.

0
0e84c3d1553e77af594676e971e2aa4a

on November 13, 2012
at 03:06 PM

I don't know if Gronk's girlfriend had PMS but my XGF did despite being extremely fit and eating a good diet. The solution to the problem was quite simple, cheap, and relatively free of risk.

Progesterone topical cream is "available over the counter" in some places and from LEF or iHerb. Start at a lower dose for the first two week period and if the results are not adequate increase the amount you rub onto your skin each day. Too much will suppress your period but that is not a serious problem and easily reversible. My XGF being a competitive athlete was of the mind set "if some is good, more is better" so she had to try more, though the results were already good. So she then accused me of getting her pregnant. Not so, she only had to reduce the progesterone dose. Progesterone is not an anabolic steroid that will make a woman run or build more muscles faster. It can have those effects indirectly by reducing down time and over-medication with NSAIDS.

You want to know why it works? OK, but just keep in mind that the explanation could be wrong yet the stuff still works great!

Our "better living through chemistry" world has filled our environment with many pollutants which have harmful estrogen-like effects on men and women. Pesticides, BPA, even some processed cooking oils, for example. The high estrogen suppresses progesterone in a woman's cycle. It helps to try to reduce your xeno-estrogen burden but hard to be completely free.

Pregesterone you buy for topical application is the real bioidentical stuff, none of this fake pharmaceutical variety like horse urine extract to mimic estrogen in HRT.

Too bad for us men that we can't overcome the worst effects of estrogen overload as readily as women.

You can verify these suggestions and explanations online from various health practitioners' websites. Jonathan Wright and John Lee come to mind as names/search terms.

Ce41c230e8c2a4295db31aec3ef4b2ab

(32566)

on November 13, 2012
at 03:28 PM

Progesterone cream.

Ce41c230e8c2a4295db31aec3ef4b2ab

(32566)

on November 13, 2012
at 03:27 PM

Tried it for many months & no effect on my cramping. I usd Pro-gets cream. I get that cramping happens for different reasons for different women, so there isn't a solution that will work for everyone.

0e84c3d1553e77af594676e971e2aa4a

on November 13, 2012
at 11:10 PM

I could not guarantee anything, but the only two women I know who needed it for PMS had good results. Must be started at the right time and continued only two weeks per cycle then discontinued two weeks. The products might differ in concentration and absorption. I could tell you what brand XGF used but two months ago she said she could not get it in Europe easily so I sent her the two different tubes she left here the year before. I think one was NOW brand and the other was from LEF. "Correct the spice" as they say in cooking, titrate to get the result, but within a range no risk to try higher

0
B0af9e9c1c0acf1dc93d4dc9d6bcafb1

on November 13, 2012
at 10:32 AM

I second cutting out FODMAPs, it helps mine if I am sticking to it at the time. Fructose malabsorption can reduce your ability to absorb zinc (and other stuff) because of the fodmaps hanging around in the gut.

0
Ed6dc87a0d201bfc23e36b2cd2e37704

on October 11, 2012
at 04:52 PM

Well if you in fact do have SIBO, which I believe is more formally known as Bacterial Overgrowth Syndrome (BOS), that is a malabsorptive disorder and a potentially serious medical condition. To be clear, this would mean you're malabsorbing everything, including fat (steatorrhea), vitamins, and proteins. This definitely means diarrhea, and possibly dyspepsia (stomach ache), bloating and/or flatulence, and probably weight loss since you wouldn't be getting all of those nutrients. If you've had this awhile (i.e., more advanced case) then you can have very serious complications secondary to vitamin deficiencies and protein malabsorption (cachexia), including anemia, muscle spasms, night blindness, dermatitis, etc. If this all sounds familiar, then definitely seek medical attention! I'm guessing it's just another case of "google diagnosis" gone awry :)

Current theories of nutritional causes of PMS include magnesium and calcium deficiencies. They've all but ruled out B6 deficiency, derangements in glucose metabolism, and fluid-electrolyte imbalances as causes, for what that's worth. It's plausible that it's due to a difference in hormonal changes or in sensitivity to hormonal changes.

My best recommendation is to eat natural (e.g., grass-fed) foods provided you can afford to, and to make sure you eat lots of veggies - especially your greens - and some fruits. This should ensure that you have your nutritional bases covered. Combined with regular exercise, that may help regulate your hormones better as well.

High-dose vitamins aren't always a great idea (and doesn't seem like a good long-term plan), so I'd caution against that. Make sure you do your research on dosages to ensure you aren't hurting yourself.

8634d4988ced45a68e2a79e69cc01835

(1617)

on October 11, 2012
at 09:27 PM

Right. B6 toxicity is no joke! And so many multivitamins have loads of it!

Ff5307d657eb7bbcc526dc7cf1ddd7fd

(460)

on October 20, 2012
at 03:51 PM

Thanks for your input, RyanMT. I agree high doses of vitamins can be problematic - in fact, I haven't tried the thiamine protocol yet because I am worried about this. I just wanted to throw it out there and see if anyone has tried it. Thiamine seems to be quite safe, but I don't get the feeling that supplementation has been studied extensively or in the long term. Although, I guess the question also becomes, is it likely safer than the alternative, which for me is doping up on NSAIDs two or three days each month? I don't have the answer for this, unfortunately.

0
E187ec3816e673bb14eb3a96e29beca2

on September 27, 2012
at 02:33 PM

There is a lot of research on coconut oil to relieve, eliminate PMS, and truly balance hormones. The PMS, menstrual issues stems from an unbalanced diet,meaning nutrients your body needs it does not receive. As well, as being too acidic. Your body needs extra nutrients during your period and with it barley managing as it is, this results in cramps. So depending on your diet, how consistent your blood sugar is, and your vitamin/mineral balance. I would suggest a quality multi-vit,with phyto-nutrients, but I highly advise researching or trying coconut oil,virgin, unrefined and maybe start with a teaspoon with water x2/day. I think your research is correct as well, but taking not just thiamin but b-complex could be an idea is thiamine alone does not do the trick.

0
7f38017aac27be3077cc5e18ccedf7a8

on September 22, 2012
at 02:42 AM

My severe cramping and other unpleasant symptoms like nausea/moodiness went almost completely away after taking omega-3 supplements (fish oil mostly as flax oil was not effective) and occasionally taking "Magnelevures" which include magnesium, L-Glutathione, Vitamin B6 and Thiamine.

0
C0c839648b31512515daaffe8e4e9ad1

on August 25, 2012
at 12:36 PM

I would suggest removing everything from your diet as well that is not extremely safe and paleo.

Ff5307d657eb7bbcc526dc7cf1ddd7fd

(460)

on August 25, 2012
at 01:03 PM

I think this is a good start for many people. However, an extremely clean paleo diet can still be quite problematic for someone with SIBO. I had been gluten-free for several months before going paleo, and while going gluten-free had a very positive effect on my digestion, going paleo at that point had a negative effect on my digestion. A kind of combined paleo and FODMAP approach works much better for me. Since I suspect SIBO could be related to dysmenorrhea, I think this is worth noting.

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