Nutrition Q&A
with Linda B. White, M.D.
Allergy-free Glucosamine
Q: Can people who are allergic to sulfa drugs safely take glucosamine sulfate?
A: Yes. Sulfates, sulfur combined with oxygen, naturally occur in the body. In fact, sulfur is an essential nutrient for joint tissue and is contained in many foods including fish, eggs, meats, cabbage, brussels sprouts, garlic and onions. Glucosamine sulfate, a naturally occurring substance in joints, can be taken in supplement form to reduce arthritis. It is an extremely small molecule that is easily absorbed and unlikely to trigger allergic reactions. Studies show that it is well tolerated. Sulfa drugs, on the other hand, are a class of antibiotics generically called sulfonamides. These relatively larger, synthetic and completely different molecules can cause severe allergic reactions in susceptible people.
B6 for PMS
A: A lot of customers come in asking about vitamin B6 for easing PMS symptoms. What does the research show?
A: No one knows exactly what causes PMS, but multiple factors probably play a role. Because of that, chances are a single remedy won't help everyone. More than a dozen controlled trials have investigated the effect of vitamin B6 on PMS. Most, but not all, studies found benefits. However, these benefits weren't huge, and the study sizes were usually small.
Safe dosage ranges for B6 are 50 to 100 mg/day. Long-term use at doses higher than 500 mg/day can cause nerve toxicity.2 One reason not all women respond to vitamin B6 may be an inability to convert it to its active form.3 Vitamin B6, also known as pyridoxine, is converted in the liver to a more active form, pyridoxal-5 phosphate. Some people may need extra magnesium and B12 to make the conversion.3
Along these lines, don't forget calcium, which, at a dose of 1,200 mg/day, has also been shown to reduce PMS symptoms.
Before you recommend B6, consider this: A 1997 study found that chasteberry extract was more helpful than B6 in reducing PMS symptoms. Specifically, chasteberry produced a more significant reduction in breast tenderness, edema, tension, headache, constipation and depression. According to the women patients, 36 percent of those who took chasteberry were free of complaints vs. 21 percent for B6.4
In two earlier German surveys involving 1,542 women, nine of 10 women experienced some amount of relief. One-third of the women had complete resolution of PMS symptoms; another 57 percent reported significant improvement.5,6 This led doctors to rate chasteberry extract as good or very good 92 percent of the time. Chasteberry alters reproductive hormones released by the hypothalamus and pituitary to lower the estrogen to progesterone ratio, which is thought to contribute to PMS.
Herbal Acne Solutions
Q:In our store, we get lots of questions about natural acne treatments. Any advice or recommendations?
A: Treatments will vary depending on whether a customer has teenage or adult acne. The latter, which usually occurs in women, often involves menstrual irregularities and requires a different approach.
The one study I know of that deals with teenage acne involves tea tree (Melaleuca alternifolia) oil, which is a broad-spectrum antimicrobial and anti-inflammatory. In this Australian study, 124 patients with acne applied either a 5 percent tea tree oil gel or a 5 percent benzoyl peroxide lotion (an antiseptic). Both treatments significantly reduced the acne. The tea tree oil took longer to work, but caused fewer side effects such as minor skin irritations.1 Lavender (Lavandula angustifolia) essential oil, an antimicrobial, anti-inflammatory and astringent, is another acne remedy. Just dot it onto individual blemishes.
Another underlying problem with acne is that dead skin cells can block oil glands. Fruit acids, also called alpha-hydroxy acids, can exfoliate these cells. Fruits rich in alpha-hydroxy acids include pineapple (especially the husks), grapes and strawberries. Customers can either blend and apply the fruits themselves or use creams that contain fruit acids.
Normalizing excess reproductive and adrenal hormones may help alleviate adult acne. A sluggish liver can't clear hormones, which in turn, can aggravate acne. Burdock (Arctium lappa) and dandelion (Taraxacum officinale), taken internally, are liver tonics. They also contain inulin, which activates an immune mechanism called the alternate complement pathway. Improving this pathway may help rid the skin of bacteria. Both herbs may be taken as tinctures (3060 drops/day) or as tea—one cup two to three times daily.
Chasteberry (Vitex agnus castus) can also help regulate a woman's reproductive hormones. To combat premenstrual breakouts, most naturopaths recommend 40 drops of liquid extract or one capsule of the dried extract each morning.
Linda B. White, M.D., is a freelance writer and editor and the co-author of Kids, Herbs and Health (Interweave Press, 1999).
References
1. Bassett, IB, et al. A comparative study of tea-tree oil versus benzoyl peroxide in the treatment of acne. Med J of Australia 1990;153:455-8.
2. Murray MT. A comprehensive evaluation of premenstrual syndrome. Am J Nat Med 1997 Mar;4(2):6-22.
3. Diegoli MS, et al. A double-blind trial of four medications to treat severe premenstrual syndrome. Int J Gynaecol Obstet 1998;62:63-7.
4. Lauritzen CH, et al. Treatment of premenstrual tension syndrome with vitex agnus castus controlled, double-blind vs. pyridoxine. Phytomedicine 1997;4:183-9.
5. Dittmar FW, et al. Premenstrual syndrome: treatment with a phytopharmaceutical. Therapiewoche Gynakol 1992;5:60-8.
6. Peteres-Welte C, Albrecht M. Menstrual abnormalities and PMS: vitex agnus castus. Therapiewoche Gynakol 1994;7:49-52.
