EP.336/ Being low in these minerals could worsen your period (and endo) pain
This week I want to highlight three key minerals that when you’re low in, can cause you more period pain. These have all been associated with endo in the research too, and of course, as a classic symptom of endo is horrific period pain, replenishing these minerals could help you improve your experience of your period with endometriosis,
Let’s get to it.
Magnesium
Number one I think you’ll probably not be surprised by is magnesium. Magnesium helps to ease muscle tension and can lessen the contractions in the uterus during menstruation. It also helps to regulate our levels of inflammatory prostaglandins by inhibiting their production.
For those of you who are new to my podcast, prostaglandins, specifically prostaglandin E2, are inflammatory types of immune chemicals that are involved in many processes in the body, but particularly menstruation and ovulation. When their levels are high, they can cause heat, swelling, fever and pain - and dysmenorrhea, a.k.a period pain (as well as painful ovulation).
These suckers have been found to be elevated in people with endometriosis, dysmenorrhea and heavy menstrual bleeding, so getting them down is absolutely key to managing our pain.
Research has shown a strong association between low levels of magnesium and dysmenorrhea, and additionally, magnesium supplementation has been shown to be an effective treatment for period pain, and also PMS.
Typically, if supplementing, we use 150mg - 450mg of magnesium glycinate, though some practitioners go for 500mg. Magnesium glycinate is best for absorption.
Food sources of magnesium include:
Avocados
Beans, especially black beans and lentils
All leafy greens, darker the better
Brown or black rice
Brazil nuts
Almonds
Pecans
Cashews
Sesame seeds (tahini is the easiest way to absorb them)
Sunflower seeds
Cacao and dark chocolate
Calcium
Calcium plays a role in muscle contractions and research has shown that low calcium levels can worsen menstrual cramping (as well as PMS, by the way). Studies have also shown significant improvements in period pain with calcium supplementation and have linked low calcium levels and intake with endometriosis.
In terms of supplementing, calcium supplementation can be dangerous if you take too much or don’t have healthy levels of other nutrients like vitamin D, to help you absorb calcium to where it’s needed, like your bones. Instead, the calcium can build up in your blood stream. The NHS state that taking less than 1500mg is safe and unlikely to cause harm. Another, safer way to take calcium supplements is to use food based calcium, in the form of egg shell powder - yes, really! Egg shell powder is safe to eat but has also been shown to absorb just as well as calcium supplements, and in some studies, even more effectively. You can buy egg shell powder to use in this way, or you can make your own, and I’ve linked to a few ways to do this in the show notes, but I am working on my own recipe for this too. 1g of egg shell powder can provide you with 50% of your daily calcium needs and you can add it to coffee, sauces, smoothies, etc.
If you don’t fancy eating egg shell powder, calcium sources include:
Seeds including chia seeds, sesame seeds and poppy seeds. With sesame, it’s best to eat these in the form of tahini or ground, as we often don’t digest them otherwise.
Certain beans have calcium in varying degrees, with some like white beans, providing more than others
Healthy soy products such as tempeh, tofu and edamame beans (not heavily processed fake meat)
Dairy foods
Leafy greens such as kale, collard greens, mustard greens, bok choy, nettles and spinach. However, it’s worth noting that even though spinach contains calcium, it’s high levels of oxalate inhibit absorption, so the other forms of leafy greens are more beneficial.
Sardines and tinned salmon, and unfortunately for many us, you need to eat the edible bones to get the calcium from these two, so probably not a viable option for many people listening, but if you’re not bothered by that, these are great options
Zinc
Lastly, let’s look at zinc. Low levels of zinc have been found in people with endometriosis, and whilst there is less research on low levels of zinc and period pain (though there is some), there are lots of studies on supplementing with zinc and the reduction of dysmenorrhea. The benefits of zinc for period pain are due to its ability to inhibit prostaglandin production, lower oxidative stress (a process which causes more inflammation) and to limit uterine contractions by improving blood flow.
The doses vary, but one study used 40mg per day for three cycles, whereas another used 50mg twice a day in the four days leading up to menstruation and yet other research showed using 30mg once to three times a day, again in the four days leading up to menstruation, prevented dysmenorrhea.
Long term, high doses of zinc come with risks of copper deficiency, but at these levels, especially if you’re only using zinc in the lead up to your period, it is very unlikely. Generally, research indicates doses of 40mg and under are safe, though in contrast, the NHS advises not to take more than 25mg a day unless advised to by a doctor. Some practitioners and research suggest also taking 1mg-2mg of copper per day if you’re also taking zinc, though this is not the general consensus across the board with the lower doses. One thing to note is that if you do take both zinc and copper, take them at separate times of the day, because zinc affects copper absorption which is why copper can become depleted. Finally, take zinc after meals because it can cause nausea on an empty stomach.
Food sources of zinc include:
Pumpkin seeds
Hemp seeds
Sesame seeds
Cashews
Almonds
Oats
Shellfish, especially oysters and prawns
Red meat and beef liver
Turkey
Beans and lentils
A word on iron
Finally, I wanted to give a quick word to iron. Low iron levels won’t worsen period pain, but they can cause worsened symptoms like fatigue, dizziness, headaches and low mood, etc. and whilst it may sound counterintuitive, it can also cause heavy bleeding in some people, though of course, commonly can cause lighter bleeding.
Show notes
Magnesium
https://pubmed.ncbi.nlm.nih.gov/2675496/
https://www.ijwhr.net/pdf/pdf_IJWHR_624.pdf
https://ijwhr.net/pdf/pdf_IJWHR_195.pdf
https://pmc.ncbi.nlm.nih.gov/articles/PMC3626048
https://www.jle.com/fr/revues/mrh/e-docs/magnesium_in_the_gynecological_practice_a_literature_review_309489/article.phtml
Calcium
https://ijwhr.net/pdf/pdf_IJWHR_195.pdf
https://pmc.ncbi.nlm.nih.gov/articles/PMC7834752
https://www.cell.com/heliyon/fulltext/S2405-8440(24)11191-7
https://pmc.ncbi.nlm.nih.gov/articles/PMC3626048
https://www.ajog.org/article/S0002-9378(34)90970-4/abstract
https://pubmed.ncbi.nlm.nih.gov/1924661/
https://pubmed.ncbi.nlm.nih.gov/10763903/
https://www.tandfonline.com/doi/abs/10.1080/07315724.2000.10718920
https://pmc.ncbi.nlm.nih.gov/articles/PMC6221107
https://www.dietaryguidelines.gov/food-sources-calcium
https://pubmed.ncbi.nlm.nih.gov/23607686/
https://scijournals.onlinelibrary.wiley.com/doi/abs/10.1002/(SICI)1097-0010(199909)79:12<1596::AID-JSFA406>3.0.CO;2-A
https://www.nhs.uk/conditions/vitamins-and-minerals/calcium/
https://www.peteandgerrys.com/blogs/field-notes/diy-eggshell-calcium-powder
Zinc
https://pmc.ncbi.nlm.nih.gov/articles/PMC10184220/
3?utm_source=chatgpt.com
https://pubmed.ncbi.nlm.nih.gov/17289285/
https://pubmed.ncbi.nlm.nih.gov/35226276/
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