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A Woman's Guide to Vitamins, Herbs, and Supplements
By Deborah Mitchell
St. Martin's PressCopyright © 2008 Lynn Sonberg Book Associates
All rights reserved.
Women's Medical and Health Concerns
Approximately 75 percent of adolescent girls and at least 12 percent of women have to face it: the pimples, bumps, cysts, redness, and inflammation that greet them in the mirror not just for a day or two but for weeks, months, even years. Acne, also known as acne vulgaris, is a chronic skin condition that affects approximately 60 million Americans, according to the American Dermatological Association. Acne is not just a teenage phenomenon: 20 percent of adults have active acne, and up to half have at least one episode during adulthood.
Although acne can range from mild to severe, it all begins the same way: oil glands (sebaceous glands) in the skin secrete an oily substance (sebum) into the hair follicles. The sebum lubricates the hair and skin, but if too much sebum is produced, it can block the skin pores and trap dead skin cells. A plug then forms and develops into a closed comedone (whitehead) or open comedone (blackhead). If bacteria get into the come-dones, the skin becomes inflamed and pimples form. Sometimes pimples fill with pus (in which case they're called pustules) and invade deep into the skin, forming painful sacs called cysts. Because pustules and cysts form scar tissue when they heal, they can leave pits in the skin.
Acne typically first appears during adolescence and is largely caused by hormonal changes. These changes stimulate the sebaceous glands to increase sebum production, a process that usually subsides by age 20. Yet acne can also appear for the first time in adults, and here the cause may be a genetic predisposition, hormonal changes (especially related to menstruation or high testosterone levels), use of certain prescription medications (e.g., lithium, corticosteroids, oral contraceptives, phenytoin), or a reaction to certain cosmetics.
Prevention and Treatment
Although there are no known ways to prevent acne, you can significantly reduce its severity and impact if you:
Use mild soap when you wash your face.
Avoid use of cosmetics that contain oil, which can clog your pores, or those that contain lanolin, isopropyl myristate, sodium lauryl sulfate, laureth-4, D&C red dyes.
Wash your hair frequently.
Avoid irritating or picking any pimples.
Eat a whole-foods diet that includes four to five servings of green vegetables daily (chlorophyll is good for the skin) and lots of fiber.
Perhaps you've heard the expression "feed your skin," and that's what natural supplements can do. Be patient, however, as it can take 6 to 8 weeks before you see significant results.
Vitamin A or beta-carotene. Up to 25,000 IU (see the box on page 244 for unit conversion) daily of vitamin A is considered safe for postmenopausal women; a comparable dose of beta-carotene is 30,000 mcg. For women who are pregnant or who could become pregnant, take no more than 10,000 IU daily of vitamin A or 6,000 mcg of beta-carotene.
Tea tree oil. When applied to acne, it may reduce bacteria and improve symptoms, including inflammation. Compared with benzoyl peroxide, tea tree oil gel is just as effective but has fewer side effects (e.g., burning, dryness, stinging, itching). Apply a drop or two to each lesion three times daily or use 5% gel twice daily.
Vitamin B complex. Two to three times daily, take 25 to 50 mg. Also include extra vitamin B6 — take 25 mg twice daily for severe acne, once daily for mild to moderate acne. One study also found that women with premenstrual acne alleviated acne flare-ups before their menstrual cycles when they took 50 mg of vitamin B6 daily.
Copper and zinc. Begin with 30 mg zinc twice daily for three months, then reduce zinc to once daily and add 1mg copper daily, because long-term zinc use can reduce copper levels.
Aloe vera. Squeeze the gel from the leaves of this plant or use a commercial gel that contains aloe vera to soothe your skin. Apply as needed.
Of Special Interest to Women
Blame it on hormones: Adolescent girls and women of all ages are much more likely than men to experience mild to moderate acne, according to a 2008 study in the Journal of the American Academy of Dermatology. For some women, hormone fluctuations two to seven days before the menstrual period begins can trigger an outbreak of acne. Women who have polycystic ovary syndrome typically also have high levels of testosterone, which may cause acne. Other hormonal changes that can trigger acne include pregnancy, starting or stopping birth control pills, or hormone therapy. Recent research also indicates a relationship between DHEA levels and acne in women (see "DHEA").
If you are pregnant and have acne, be especially careful, as many of the medications used to treat acne, including retinoids, isotretinoin, and the antibiotics tetracycline, minocycline, and doxycycline, can harm the fetus.
Adrenal fatigue is a syndrome — a collection of signs and symptoms — that develops when the adrenal glands become overburdened and no longer can efficiently produce hormones. Typically adrenal fatigue occurs in three stages: (1) the adrenal glands respond to stress by increasing the secretion of adrenal hormones, including adrenaline and cortisol; (2) when stress is chronic or persistent, it causes excessive production of certain hormones, especially cortisol, in an attempt to alleviate the damage to the body caused by the stress; (3) when the adrenal glands can't make enough cortisol in response to chronic stress, they become fatigued and cortisol levels drop excessively low. Throughout this process many symptoms can occur, ranging from mild to debilitating.
Cortisol's most important function is to help the body respond to stress, be it physical (e.g., surgery, infections), emotional, and/or environmental, by converting proteins into energy, fighting inflammation, and releasing glycogen for energy. It also helps the body recover from infection, maintain blood pressure, and regulate metabolism of fats, proteins, and carbohydrates. When cortisol performs these duties for a short time, as it was designed to do, the body usually responds well. If, however, chronic stress keeps cortisol levels high, then cortisol attacks the body and weakens the immune system. The result is adrenal fatigue.
Many physicians do not recognize adrenal fatigue and so it is often undiagnosed or misdiagnosed. An expert on adrenal fatigue, Dr. James Wilson, author of Adrenal Fatigue: The 21st Century Syndrome, notes that approximately 80 percent of people in North America experience adrenal fatigue at least once during their lifetime. For some people it is a temporary condition, lasting only a few days or weeks; for others, it lingers for months or years.
One way to help diagnose adrenal fatigue is the ACTH (adrenocorticotropic hormone) challenge test. When this hormone, which is made by the pituitary gland, is injected into the body, an increase in adrenal hormone should occur. If it does not, adrenal fatigue is a probable diagnosis.
Adrenal fatigue can be caused by genetics or by various stressors, including nutritional deficiencies, chronic physical and/or emotional stress, exposure to environmental toxins (e.g., secondhand smoke, household solvents, pesticides, food preservatives), use of stimulants (e.g., caffeine, nicotine, alcohol, sugar, cocaine), and chronic infections, especially respiratory (e.g., bronchitis, pneumonia).
Regardless of the cause, adrenal fatigue can leave you with tiredness, muscle weakness, swollen fingers and/or toes, swollen lymph nodes in the neck, intolerance to cold, low blood pressure, joint and muscle pain, constipation, sleep disturbances, depression, and allergies, among other symptoms. Fortunately, adrenal fatigue can be prevented and treated successfully using a natural approach.
Prevention and Treatment
Your best defense against adrenal fatigue is a nutritious diet, adequate sleep, conscientious stress reduction and management, and avoidance of toxins. Temporary adrenal fatigue, which is caused by stressors, will respond to lifestyle changes and supplementation. Permanent cases, which can result from surgical removal of the pituitary or adrenal glands, congenital adrenal hyperplasia, or Addison's disease, require hormone replacement but can also benefit from nutritional supplements. A stress reduction program is strongly recommended to go along with any supplement program.
Vitamin C. Taking 3,000 mg daily can help reduce elevated cortisol levels, psychological stress, and blood pressure, according to several studies.
DHEA. When the adrenal glands are overworked, they lose their ability to produce adequate DHEA. Supplementation with DHEA may also help protect against overproduction of cortisol by the adrenal glands. Have your DHEA levels checked before beginning supplementation (see "Of Special Interest to Women"). A typical dose is 20 to 50 mg per day.
Vitamin B5 (pantothenic acid). Vitamin B5 plays a key role in adrenal health and is necessary for the production of cortisol. The recommended dose is 1,500 mg daily.
Magnesium. This mineral plays a major role in adrenal function. Supplement with magnesium aspartate, 100 to 300 mg daily.
L-theanine. This amino acid increases the body's levels of gamma-aminobutyric acid (GABA), a neurotransmitter that promotes relaxation and a sense of well-being, and also helps to restore sleep. A suggested dose is 100 to 400 mg daily.
Asian ginseng. Ginseng can improve adrenal function, reduce high cortisol levels, and improve the ratio of cortisol to DHEA to a healthier balance (see "DHEA"). A suggested dose is 100 mg twice daily.
Melatonin. A nightly dose of 2 mg of melatonin can help balance the DHEA/cortisol ratio, which is important for adrenal health. This hormone can also regulate sleep and reduce stress.
Of Special Interest to Women
Adrenal fatigue affects both men and women, although it is more common among middle-aged women. This trend may be related to hormone fluctuations that occur as women move into menopause.
One of the hormones that declines with age is DHEA, which is a precursor to critical hormones, including progesterone, estrogen, and testosterone. DHEA supplementation is often recommended for adrenal fatigue, but you should consult your doctor and have your DHEA levels checked before taking the hormone. DHEA levels should be monitored during treatment to make sure the hormone is being metabolized properly. Improper DHEA supplementation can cause male characteristics, including deepening of the voice, facial hair, and hair loss. It may also cause acne, insomnia, headache, weight gain, and abnormal menstrual cycles.
The absence of menstruation — whether during puberty or later in life — is called amenorrhea. Females who have not started menstruating by age 16 have primary amenorrhea; those who were menstruating but stop having periods for three months or longer have secondary amenorrhea. Secondary amenorrhea is much more common than the primary form, and usually the cause is not serious. Pregnancy, for example, is a cause of secondary amenorrhea.
Amenorrhea is also a sign of other conditions and situations (see "Causes/Risk Factors"). In addition, depending on the cause of amenorrhea, women may experience headache, vision changes, excessive hair growth on the face and/or torso, and a milky discharge from the nipples.
In many cases, the cause of primary amenorrhea is unknown. Possible reasons include dysfunction of the ovaries, abnormal formation of the reproductive organs, and problems with the pituitary gland and/or the brain and central nervous system. Secondary amenorrhea may be attributed to use of contraceptives, breast-feeding, stress, medication (e.g., antidepressants, antipsychotics, some chemotherapy drugs), chronic illness, hormonal imbalance, polycystic ovary syndrome, low body weight, excessive exercise, thyroid dysfunction (hypothyroidism), pituitary tumor, scars on the uterus (due to Caesarean section or uterine fibroids), and premature menopause.
Prevention and Treatment
If you experience amenorrhea, consult your gynecologist to determine the cause, even if you think you know the reason. She or he may recommend you undergo a hormone evaluation and/or complete physical examination. Because amenorrhea is a sign and not a disease in itself, treatment involves addressing the underlying cause, such as hypothyroidism or hormone imbalance. Stress reduction and improved nutrition can go a long way toward correcting amenorrhea, as can natural supplements.
Calcium, magnesium, and vitamin D. Regardless of the cause of amenorrhea, protect yourself against bone loss by taking these bone-sustaining supplements: calcium, 1,000 mg daily in divided doses; magnesium, 500 mg in divided doses and two hours after calcium; and vitamin D, 400 IU daily.
Chaste tree berry. This herb balances prolactin (high prolactin levels are a sign of amenorrhea), helps regulate the menstrual cycle, and increases progesterone production. An effective dose is 40 drops of extract in water, taken daily for six months.
Vitamin B May reduce high prolactin levels. Dose is 200 mg daily.
Of Special Interest to Women
It is tempting to view the premature cessation of your menstrual period as a benefit (goodbye cramps, pads, and tampons), but there's a downside: Bone density loss and the increased risk of osteoporosis could be a major concern if you experience amenorrhea for more than three or four months. Therefore, make sure you get adequate calcium, magnesium, and vitamin D and talk to your doctor about how to maintain your bone health.
Anemia is a general term for a condition in which there is insufficient oxygen in the blood. The most common form of anemia — and the one that affects women most often — is iron-deficiency anemia, which we focus on here.
Iron-deficiency anemia occurs when there isn't enough iron in the blood to manufacture hemoglobin, the substance in red blood cells that transports oxygen from the lungs to the rest of the body. Twenty percent of women of childbearing age have this type of anemia. Iron-deficiency anemia can be difficult to detect during the beginning stages because the symptoms mimic other conditions. Some of those symptoms include headache, loss of appetite, pale skin, shortness of breath during exercise, fainting, weakness, sore tongue or mouth, brittle nails, rapid heartbeat, and fatigue.
The main cause of anemia in women is menstrual bleeding. Normally, women of childbearing age lose 20 to 40 mg of iron every month during menstruation. This fact, combined with an insufficient intake of iron from food and/or supplements, can result in iron-deficiency anemia. Other causes include gastrointestinal bleeding, pregnancy, parasites, recurring infections, and poor absorption of iron due to digestive disorders, poor diet, use of diuretics, or kidney problems. One risk factor for iron-deficiency anemia you can control is diet: A diet that contains few iron-rich foods or foods that interfere with iron absorption can put you at significant risk for anemia.
Prevention and Treatment
You can help prevent iron-deficiency anemia if you watch your dietary iron intake. Foods with the highest iron values include liver and other organ meats (go organic if you choose these foods), but other sources include beans (e.g., black, kidney, lima, chickpeas, lentils), brown rice, clams, dried fruits (e.g., prunes, raisins, apricots), enriched cereals, nuts, oysters, and pumpkin seeds. Foods that interfere with iron absorption should be eaten in limited quantities, including uncooked kale and spinach, almonds, coffee, black tea, and colas. Eating the following foods with iron-rich foods will enhance iron absorption: broccoli, brussels sprouts, cantaloupe, green and red bell peppers, oranges, orange juice, tomatoes, and white wine.
Smart diet choices, along with iron and other complementary supplements, can very effectively treat iron-deficiency anemia.
Iron. The iron supplement that is best absorbed and most gentle on the gut is ferrous peptonate, followed by ferrous chelate and gluconate. Always take iron supplements with food. Have your iron levels checked before beginning supplementation. A typical dose is 100 mg daily, but allow your physician to determine the best dose for your needs.
Vitamin C. Take vitamin C along with your iron supplement to enhance absorption of iron. Dose: 500 mg daily.
Dandelion. This herb may enhance your body's ability to absorb iron from food and supplements. Try 5 to 10 mL of tincture in water three times daily.
Vitamin A/beta-carotene. Include vitamin A or beta-carotene to help you digest the iron in your supplement. Dose: 5,000 IU daily.
Excerpted from A Woman's Guide to Vitamins, Herbs, and Supplements by Deborah Mitchell. Copyright © 2008 Lynn Sonberg Book Associates. Excerpted by permission of St. Martin's Press.
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