The End of PMS with Vitamin B6 and Other Serious Cures

PMS cureThank you to my nutrition professor who first taught me about vitamin B6 (pyridoxine) for PMS. It is reliable treatment for premenstrual mood problems including PMDD.

I still remember B6 as the eureka moment in the way I thought about periods. Suddenly, I had much higher expectations of how healthy a period can be.  Periods should arrive smoothly and without symptoms.

PMS is common, but it’s not normal.

The big question is: Why does B6 work so well? How can we have a magic bullet, when we don’t yet fully understand what PMS even is?

What is PMS?

Our current understanding is that premenstrual syndrome results from a complex interplay of GABA, serotonin and a progesterone metabolite called allopregnanolone, (ALLO).  ALLO has a calming, valium-type effect on the GABA receptor. Swedish researcher Ericka Timby found that the GABA receptors of PMS-sufferers are less sensitive to ALLO than normal. Receptor resistance may be caused by serotonin deficiency, chronic inflammation, and histamine or mast cell activation.

B6 relieves PMS

The activated form of B6 (pyridoxal 5-phosphate or P5P) works at almost every aspect of the PMS story. It’s essential for the synthesis of steroid hormones, particularly progesterone. It’s involved in the manufacture of the key neurotransmitters: both GABA and serotonin. B6 also promotes anti-inflammatory prostaglandins and assists with the healthy detoxification and clearance of both estrogen and histamine (a common cause of PMS).

B6 is found in foods like fish, poultry, and nuts. But my experience is that most people need a supplement. Speak with a clinician before taking more than 50mg per day because high doses can cause nerve damage.

Other Serious Cures for PMS:

  • Magnesium enhances GABA activity, regulates the stress response, and normalizes the action of progesterone on the central nervous. The supplement works so well for PMS that some scientists have suggested that magnesium deficiency is the main cause of the condition.
  • The herbal medicine Vitex or Chaste tree has done well in clinical trials for PMS and PMDD. Vitex supports progesterone and lowers prolactin.
  • Keep your gut bacteria healthy so they can do their job of removing estrogen and estrogen metabolites. Healthy gut bacteria also enhance GABA activity.
  • Cut back on alcohol because it depletes the body of ALLO.
  • Avoid inflammatory foods like sugar, gluten, and A1 milk because they activate mast cells and disrupt the GABA receptor.

Lara Briden, Naturopathic doctor and period revolutionary

51 thoughts on “The End of PMS with Vitamin B6 and Other Serious Cures”

  1. I have read many articles about medical cannabis and how it can help you in terms of chronic pain, bone injuries, eating disorder/anorexia, anxiety disorders and panic attacks, inflammation, even cancer and a lot more. Like this article blimburnseeds.com/news/marijuana/news/industry/kyle-kushman-vegamatrix-cannabis-cultivation/. Cbd and thc are also new to me and I don’t even smoke. Alternatively, they’ve also found new ways to infuse cannabis on food and beverages. If this is true I can’t find any solid conclusive evidence that speaks to its efficacy. Any personal experience or testimonial would be highly appreciated. Thanks

  2. Hello Lara
    During which phase is best to take VItex (for PMS , and other above mentioned issues by you) to make more progesterone and to lower prolactin. Thanks

  3. Would love for you to do a specific article for PMDD and PME. Awareness and correct diagnosis are increasing slowly but the treatment options are still limited when it comes to Natural support of these severe hormonal mood disorders hat effect 5 million women in the US of which 15% are estimated to commit suicide in their lifetime in the face of PMDD.

  4. Hi Lara! I read your book in less than a day last month! (I was desperate!) I am 41 and have been having heavy, clotty periods with lots of pain! Per you recommendation in the book I have been taking, Magnesium, Tumeric, Zinc, B6 and selenium. After one month I just had my first period I am happy to say my blood flow and clot problem is gone. I think I bleeded 1/3 of what i normally bleed. It was about 110 ml! So i guess i was bleeding too much before. But i still had cramps not as bad but still bad for two days and still lingering on and off pain at my 6th day even though i am not really bleeding any more…. So my question to you is: Should just keep taking those supplemets and wait another two months before I decide to do add vitex? Or do you think i should give vitex and DIM a try? P.S I haven’t done any dietary changes. I am NOT gluten or dairy free… Thanks Lara! I adore you I truly do!

  5. I took 50mg of B6 for 5 years as part of a multivitamin. I started getting nerve damage symptoms after 4 years but didn’t work out B6 was connected. I stopped 4 months ago and blood levels revealed elevated B6. I’m really disappointed because it did help my PMT dramatically and it’s now back with various vengeance.

  6. Hi Lara, can 30mg of P5P cause terrible nightmares, I thought that nightmares were from low B6, but since taking only 30mg they have been terrible.

      • Thanks Jane, that’s really interesting. I thought anything over 100mg was high not 30mg. Any other symptoms that you know of? I have read about nerve damage.

        • Hi, most sources say issues start with doses over 100mg but there are plenty of people reporting problems on much less, especially when taking it for an extended period of time. I took 50mg of B6 in the P5P/PLP form for 5 years and started getting symptoms after 4 years but didn’t realise it was that. My blood levels were found to be elevated.

          Symptoms can include tingling, muscle twitching, painful feet, ear ringing, photosensitivity, noise sensitivity, heart palpitations, feeling of lump in throat, seizures and much more. B6 is involved with so many different bodily functions that symptoms can vary widely. https://www.mayoclinic.org/drugs-supplements/vitamin-b6/safety/hrb-20058788

          It’s a shame I can’t take it anymore as it helped my PMS a lot.

  7. If I start on b6 to treat my PMS moodiness what is a good dose to start with? Should I also use magnesium and calcium or start with one thing at a time?
    Thanks!

  8. Hi

    I am 43 and have suffered terrible mood swings due to pms for years. I was at my happiest pregnant, I was normal ?.

    I am now taking premeeze by natures aid 400mg 1 per day
    And have just added magnesium citrate with b6 1 per day 100mg mag 25mg b6

    I used to take Rhodiola buy the UK changed the herbal rules and now I need to take 4 tablets to get the same volume of drug daily.
    Can you recommend a good Rhodiola that I can buy from outside of the U.K…?

    Recently I was taking Maca root for 3 months which I felt was great …really relaxed me and stopped my craziness, then I got acne !! After 2 days of stopping Maca my skin cleared (I tested that twice)

    Should I take agnus and magnesium together only or can I add Rhodiola.

    Or would a different combination be better. .

    Many thanks for you help.
    B

  9. I just took a gander at the magnesium link and it seems it might not be the magnesium that’s helping. The study says magnesium alleviates the fluid retention, meanwhile they’re using magnesium oxide (!) which is known to be poorly absorbed and causes diarrhea (i.e. fluid loss!!).

  10. Hello! I’m trying to add supplements into my diet. Currently I’m taking a prenatal, coq10, and b complex (all from Garden of Life.) What I was wondering was if I need to add ANOTHER b vitamin. I couldn’t find anywhere on the bottle where it said anything about P5P. I’m taking this for overall heath and I was told it would help support my kidneys and progesterone levels. Should I switch to something that specifically says “P5P” or just add that kind during my LP?
    I know its dangerous to take too much.
    Thanks!

  11. When taking B6 do you recommend taking it throughout your entire cycle, during your LP, or only if you have PMS symptoms. I’m wanting to order some as I have heard many good things about it and I want to maximize my benefits without wasting it. Thanks!

  12. B6 can delay my period if I do not stop taking it a couple of days before my period is due, so I have to be careful and limit use. I don’t see this possibility mentioned- am I unusual?

    But, another time I like B6 that isn’t mentioned is when I am having trouble clearing the estrogen just after ovulation and before my 3rd high temp. Just 10 mg here and there is that final help my body needs on top of all the things I do to help my liver.

    • Yes, it does help to clear estrogen. Great point.
      I’ve never seen it delay a period, but thank you for sharing your experience.

  13. Hi there, thanks for a great site. I have started taking Angus castus for PMDD as I heard it can help. I also have PCOS too, but my main focus is trying to manage he PMDD. I am not trying to get pregnant. My PMDD makes me feel incredibly depressed, sometimes suicidal, raging angry and extremely anxious with panic attacks. It is the depression that bothers me the most and I tried agnus 20mg a day in the hope that those horrible PMDD feelings, especially the deep depression would shift a little. I’ve been on t for approx 2.5months now and the anger has definitely calmed down but the anxiety and depression seems to be getting worse. i am also completely exhausted everyday. My periods have always been irregular, they come approx every 7-8weeks and have remains the same since the Angus, which is fine. But I just don’t seem to be feeling a better or lifted at all. I have read a lot about too much progesterone making you feel depressed and I’m wondering if that’s what I’m doing to myself with this herb? By some how the anger has calmed down, but nothing else, which confuses me?……… I have beenon and off the pills for 10 years (im26now) but I stopped all pills almost a year ago and just used nothing, and now on the Angus. My gynaecologist has prescribed me HRT for my PMDD, so a constant estrogen patch and then progesterone pill only 10days per month. I’m really really trying to avoid this, which is why I took this natural Angus route, by I’m starting to wonder if the HRT is what I may really need and it’s estrogen that I need a hit of? Blood tests don’t show too much imbalance if I’m honest, the doctors all say the levels are pretty ok, just a bit higher is certain things due to the PCOS, but I haven’t had a blood test for about 9months now. So my question really is, do you think the Angus is making me feel more depressed and anxious? Do you think it’s a bad idea for my condition and symptoms? And would you recommend the HRT I’ve been given instead? As I said, I’m not taking Angus to regulate and fall pregnant, just simply to help wth the awful misery PMDD creates.
    Thank you so much for your time x

  14. Hi Lara,

    In high school my periods stopped so I went on hormonal BC to control it, only going off once in 10 years (my periods did not return.) I went off of it for good in April of this year, and with your book’s help, was able to have a period every month for about 5 months. My only issue was that I was experiencing bad PMS — anxiety, heart palpitations, irritability, headaches and extreme insomnia (about 3/4 days) before my period. Based on some of what I read from your posts, I made the assumption that I was not making enough progesterone to carry me through to my period. As a result I decided to start taking peony & licorice to help with my ovulation and hopefully spur an increase in progesterone (and reduce LH.) This month, my period did not come at all. Since the missed period (I am at day 42 now) I have been experiencing terrible sleep issues -insomnia for going on 2 weeks now. I am weary to keep taking the peony & licorice or to try anything else (Vitex, inositol, chromium, shatavari, etc.) because I don’t want it to make my insomnia worse. I have interviews this week and it is really messing with me 🙁

    I am wondering if I responded negatively because I am actually estrogen dominant and the peony/licorice increased my estrogen so much that it stopped my periods? Any input you can provide me would be so very much appreciated Lara! I have included my lab results from August, before starting on peony/licorice.

    BTW I am 5’3 and 128 pounds and have no sign of insulin resistance, according to multiple lab tests.

    Taken on day 22 of my cycle:
    Insulin: 2.7 uIU/mL
    17-OH Progesterone: 92 ng/dL
    Progesterone: 2.2 ng/mL
    Estradiol: 157.3 pg/mL
    FSH: 10.1 mIU/mL
    *LH: 50.1 mIU/mL*
    TSH: 1.41 uIU/mL
    Prolactin: 8.5 ng/mL
    Androstenedione: 136 ng/dL
    DHEA-S: 336.5 ug/dL
    Testosterone, total: 25 ng/dL

    • What day did your period come after those blood tests? The only way to interpret hormonal blood tests is to count back from the period. Were you follicular or luteal phase?
      Also, you should probably try some magnesium, if you haven’t already.

      • So after my blood test my period came back at 28 days, on August 12th. When the blood test was taken I was in luteal phase (22 days.) Then I got one more after that at a 35 day cycle in September. During that last period I was sick of the PMS and not sleeping so started on white peony/licorice and now I am sleeping terribly and skipped my periods. Definitely think something is really off here and just wanting to know if I should continue with the peony/licorice or if it has somehow thrown me off.

        Yes – 400 mg magnesium glycinate twice a day! Just as your book recommends. I believe it was part of the reason I was able to become regular immediately after coming off the pill.

        • Hi Sara,
          You didn’t ovulate in that August cycle, or at least you hadn’t ovulated by day 22. You either 1) had an anovulatory cycle, or 2) you ovulated late, and then had a very short luteal phase. In the second scenario, that elevated LH may have been a normal ovulatory surge of LH. It would be worth retesting LH to confirm that it is indeed elevated. That way you can gauge if peony & licorice is right for you or not. Without that information, I cannot really say one way or the other. If you were my patient, I’d probably be looking deeper to figure out why you’re not ovulating. Remember, you weren’t having periods before you started the Pill, so there’s something going on.

          • Hi Laura,

            I ended up getting my period at day 45 of my cycle. It only lasted 2 days but was very heavy during those 2 days (my periods seem to be getting farther apart and shorter since going off BC 6 months ago.) I went and got my hormones tested on Day 2 and these are the results:

            Androstenedione LCMS: 91 ng/dL
            DHEA-Sulfate: 267.4 ug/dL
            LH: 9.3 mIU/mL
            FSH: 4.9 mIU/mL
            Sex hormone binding glob: 104.1 nmol/L
            Testosterone, Serum: 17 ng/dL
            TSH: 1.160 uIU/mL

            Obviously we can see that my LH/FSH ratio is off but when I called that out to my gyno she did not seem convinced that I had PCOS given I don’t have any other symptoms. She said these levels fluctuate at all times of the day and that actually LF/FSH ratio was recently removed from the PCOS criteria list. In any case, I am almost positive I am having anovulatory cycles and am just trying to decide whether I should go the Vitex route (I know, not recommended given LH levels) or try natural progesterone cream to help with my low progesterone levels/sleep issues. I am worried about using the progesterone cream as I am reading some horrific articles on how utilizing even a tiny amount, pulsed, for an extended period of time can lead to progesterone buildup in fat tissue cells and subsequent increase in other hormones (testosterone, estradiol) as a result of this counter imbalance. Here is the article: https://patient.info/forums/discuss/natural-progesterone-cream-dangers-be-aware–273620 .

            What are your thoughts on this? Can utilizing progesterone cream cause other hormones to rise after an extended period? I don’t want to cause unnecessary issues for myself at this point as all else is good in my world.

            I have started on 4g of inositol a day and am going to see if this can help regulate things before I take any steps towards Vitex/prog cream but would appreciate your insight!

            Thanks in advance Dr.

          • Just to clarify about your day 22 blood test. When did your period come directly after that test? Day 28 or day 45? It makes a big difference when interpreting the result.

          • Hi Lara,

            This is Sara, responding to the thread we had going above. For some reason it wouldn’t let me click ‘Reply’ directly on your latest comment. I have left your comment below for reference.

            To answer your question, on the 1st lab test (day 22) my period came a week after it, on day 28. Then a couple months passed in which my cycles continued to get longer and my periods shorter, the latest cycle being 45 days long. The last results I posted were from a totally separate lab test I had done a few days ago, on day 2 of my current cycle. This was about 2-3 months spaced out from my original blood test (so, different cycle altogether.) Hope this helps.

            Lara Briden says
            November 6, 2015 at 7:36 am

            Just to clarify about your day 22 blood test above. When did your period come directly after that test? Day 28 or day 45? It makes a big difference when interpreting the result.

  15. Lara, have you heard abour Estro Block? Do you think it can have the same effect of B6? Push out bad estrogen … Estro Block is so expensive and hard to obtain here in Spain …

  16. Can P5P cause hair loss? I was taking it and all my fluid retention dissapeared but I was having a lot of hair loss. I’ve discovered after that is was due to a D3 deficiency that I am correcting and I am thinking to take P5P (small dose of 25mg/day) again but I am a worried if it can cause hair loss for too much estrogen clearance.
    Thank you!!

    • I’m certain that P5P will not cause hair loss. It will not push estrogen below normal. Remember the time lag with hair loss. The hair loss you experienced was because of something that happened at least three months before that.

      • Thank you so much Lara. I am taking B6 (not P5P, cause I was scared), but I will return to my P5P pills to avoid retention cause it works great. Just wanted to be sure that good estrogen will not be pushed out.
        As I said on my comment my hair loss was due to D3 deficiency (blood test showed my levels are 20.5ng/ml) and I am taking D3 pills to correct it. It seems hair loss is better now and my scalp is not burning any more (it was terrible when I was low carb. So much better now eating more veggies and fruit and of course taking D3).

  17. I am older. I was misdiagnosed with depression in my early thirties (I actually had thyroid disease causing fatigue which they said was depression) and put on such a huge concoction of drugs it literally almost killed me. I got myself off of everything but was left with a destroyed thyroid and some physical problems. I was put on BC at age 17 and on it until 37 when I went off for 3 years. I was sick all the time off it. My thyroid wasn’t being treated at that time. I have one time a month ( though it doesn’t happen every single month) where not only can’t I sleep but I feel like someone injected me with adrenaline. It’s like torture. Sleep is impossible and its physcially uncomfortable. I’ve been asking doctors and spent thousands of dollars trying to find out how to fix this. ALL doctors claim I am probably bi polar. I know I am not. This has nothing at all to do with depression or emotional highs and lows. I get this like clockwork one week before a period. Because my life was disrupted by 5 years of a misdiagnosis I missed out on meeting a man, going back to school etc. I am now getting married. My doctor tells me that until age 47 (even though it’s a less than 2% shot) I could possibly get pregnant.. you can’t try to conceive and use Vitex can you? I did try Vitex once before for a few years and the episodes didn’t stop.. maybe magnesium would help.

  18. Thank you for your article, Lara. I have read that B6 also increases cervical mucus. Since mucus production is a estrogen-driven process, why would B6 does this if it raises progesterone and helps clear estrogen?

    Also, how does B6 raise progesterone levels? Does it stimulate a gland or act on receptors?

    Thank you!

    • Because it raises LH (luteinizing hormone), which is high in some types of PCOS. I always test LH first. If it’s low, then Vitex can be used. If it’s high then Peony is better herb.

  19. Totally agree, B6 is the only thing I’ve found to be helpful – I notice a difference within an hour of taking it! I go from being really irritable, stressed, low energy, teary etc to feeling able to cope and significantly more relaxed.

  20. Hi Lara, thanks for great article.
    You mention GABA, serotonin and ALLO as a cause of PMS. Many times I came across information saying that increased level of oestrogen also contributes to PMS. Oestrogens are metabolised in the liver, so healthy functioning body should excrete excess of this hormone. However if the liver function is unmarried, excess of metabolised oestrogen will give symptoms associated with PMS. In this case it would be recommended to take supplements/ herbs supporting oestrogen metabolism in liver for example DIM. What are your thoughts?

    • Hi Dobrusia, yes, estrogen is a stimulating hormone and some women have too much. More precisely, some women have an excess of an irritating estrogen metabolites called 4-hydroxyestrone (this can be measured on urine test). Other types of estrogen – such as estradiol- are quite good for mood. I talk about this in my estrogen article. In that article, I talk about the importance of intestinal bacteria for estrogen clearance. Also, thyroid hormone and methylating supplements like B6 are important for estrogen clearance. In that article, I also talk about the sensitivity of the estrogen receptor. Iodine deficiency and systemic inflammation both cause instability of the estrogen receptor which makes women more sensitive to their own estrogens. Healthy estrogen balance is a whole-body project and usually cannot be solved by just one supplement like DIM. (Although I do prescribe DIM at times, usually together with iodine)

  21. well its awful. I am basically unable to concentrate that entire day on anything and have gained a heap of weight just from that.

  22. Hello. I have suffered from a ‘terrible’ increase in appetite around the 19th day of my 28 day cycle. I basically feel hungry the entire day and it does not go away until the next day. As weird as this sounds, is this PMS related?

  23. I have suffered from horrible PMS for as long as I can remember and it was not until I went back to school and became a Nutritional Therapist, that I learned about B6 and PMS.
    I have had bouts of depression as well over the years and have been on anti-depressants. Going on a Paleo diet, helped me give up the medicines, but I still suffered from horrible PMS.
    I had already been taking magnesium but started with B6. It took several months for me to notice a difference, but slowly things turned around.
    I am curious, I was taught never to supplement with just one B vitamin. If you do, one needs to make sure to also take a multi B vitamin as well. What are your thoughts on this?

    • It’s fine to give B6 alone for the therapeutic purpose of treating PMS. It doesn’t need to be taken everyday of the month, and can be started in the 2nd half of the cycle. Main caution is about dose. B6 is toxic in high doses, as I mention in the post. For most people, 50mg or less should be fine, especially if it’s not taken every day. And it’s important to watch total-dose. Many supplement formulas contain B6, so I often find myself tallying up all the B6 in a patient’s existing supps before I prescribe more.

      • I wish that I had known this about the Bs years ago. I am now in my 50s and suffering from various different things, mostly complications of PCOS. When I was in my early 20s after years of battles with doctors that something was wrong I finally found a doctor who listened to me and I was told I had a severe form of PMS. He started me on gesteroil (s/l) shots that caused noticeable improvements then told me to also start taking 50 mg of B6 when I was discontinued from the shots. I left it for a while and when I finally went to get the B6 I was told not to take it alone, but with B-complex. What a nightmare. I discontinued the Bs because of such major nausea and at the time never knew why. I also was not able to speak to my doctor about it as he had unfortunately passed away. Now years later and many more problems and trying to find solutions, I keep having the B6 pop up as being helpful. I can’t help but wonder if I had only listened to my doctor then rather than the lady later on at the health food store if my life might not have improved.

      • Dr. Briden,
        Could you please recommend a quality low dosage P5P supplement? I would like to find a 10mg or maybe 25mg.
        Thank you!

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