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Articles By Dr. Marni Ross
Updated Jan 2012
Updated Jan 2012
Premenstrual Syndrome
Premenstrual syndrome (or PMS) is a set of symptoms,
both physical and emotional, that as many as 80% of
women suffer from every month. Most women are able
to manage their symptoms and carry on with daily
routines, however, a small percentage of women (2-5%)
feel it has a significantly negative impact on their lives
where relationships and work are affected. Women who
seek treatment are often prescribed either the birth
control pill (to balance their hormones) and/or anti-
depressant medication (to control their mood).
Naturopathic medicine can provide a wide range of
alternatives to these options with fewer side affects.
Symptoms of PMS vary but the most common ones
include irritability, mood swings, anxiousness, sadness
and fatigue. Physical changes might be bloating, breast
tenderness, headaches and food cravings. Symptoms
usually start a few days before menses but for some
women they could even start right after ovulation, 2
weeks before menses. That’s half a month of feeling
unwell!
Numerous natural alternative therapies are available
including lifestyle changes, vitamin and mineral
supplementation, herbal medicines and natural
hormones. When it comes to treatment, what works for
one person is different than what works for another. We
are all individuals with our own unique physiological and
psychological makeup affected by different stressors.
Treatments offered for my patients vary depending on
their own individual situations but I would like to outline
a few general recommendations.
One of the first steps in treating PMS is addressing liver
function. The liver is responsible for metabolizing
estrogen so if its function is compromised, then this could
lead to excess estrogen levels and an estrogen-
dominant state (one possible underlying cause for PMS).
If the liver is determined to be “sluggish”, then various
nutrients and herbal remedies might be recommended.
Some important dietary suggestions include minimizing
sugar, refined carbohydrates, caffeine, saturated fats
and dairy products. Increase consumption of good fats
(fish, nuts, seeds), legumes, fruits and vegetables.
Studies have shown that specific nutrients are vital in
preventing PMS. These include Vitamin B6, Vitamin E,
Magnesium, Calcium (carbonate) and Gamma Linolenic
Acid (found mostly in Evening Primrose Oil). It’s always
best to get these nutrients from food but if this is not
possible then supplementation is recommended.
Herbal medicines that can be beneficial include Chaste
Tree, St. John’s Wort, Dandelion Leaf, Lemon Balm and
Ginkgo. These herbs can be extremely helpful but it’s
important to speak to a knowledgeable healthcare
practitioner before taking them to ensure the correct
dose and avoid any drug interactions.
PMS is a common condition, with varying degrees of
symptoms but as I’ve outlined here, there are many
treatment options available. PMS can be well addressed
by lifestyle changes and safe and effective nutritional
and herbal supplementation.
Irritable Bowel Syndrome: A Naturopathic
Approach
Irritable bowel syndrome (IBS) is a chronic
gastrointestinal condition that can significantly affect a
person’s quality of life. The disease can be very
frustrating to patients because it often takes a long time
and many laboratory tests to come up the diagnosis, a
diagnosis of exclusion. What that means is that all
laboratory tests come back normal but the symptoms are
there, so all other gastrointestinal disorders are ruled
out and this is the diagnosis that is given as a result.
The purpose of this article is to outline the signs and
symptoms of irritable bowel syndrome, and to discuss
the complementary and alternative treatment options
available.
IBS is defined as “abdominal pain or discomfort that
occurs in association with altered bowel habits over a
period of at least three months.” Symptoms include
constipation and/or diarrhea, flatulence/gas, abdominal
pain/bloating, nausea, anxiety and low appetite. Women
are about 1.5-2 times more likely to develop IBS than
men. Although it is present in all age groups, prevalence
of IBS seems to decline with advanced age. IBS affects
daily functioning, work, mood and lifestyle and interrupts
sleep, which leads to increased fatigue.
IBS symptoms are often compared to inflammatory bowel
disease (Crohn’s disease or ulcerative colitis) or celiac
disease but IBS does not present with any abnormal
laboratory values. Although the pathogenesis of IBS is
not known, a multi-factorial involvement of diet, gene
mutations, psychosocial factors, and immune mediated
processes is hypothesized.
IBS can be classified as diarrhea predominant (IBS-D),
constipation predominant (IBS-C), or a mixed form (IBS-
M). Since the symptoms vary so greatly between
patients, the pharmaceuticals available are mainly
targeted at symptom reduction.
Complimentary or alternative treatments have been
reported to be used in 50% of people suffering from
IBS. A primary goal of all IBS interventions is to provide
the patient with relief of symptoms and improve the
quality of life. Although the data from clinical trials may in
some cases not provide strong evidence for benefits of
dietary modification, it remains the primary non-
pharmacological clinical intervention for IBS patients;
many healthcare practitioners successfully use exclusion
diets.
IBS studies indicate a positive relationship between fat
intake and increased stool number and diarrhea. Intake
of carbohydrates can also aggravate IBS symptoms.
Offending carbohydrates include fructose and fructose-
containing products such as soft drinks, cereals, and
packaged/ baked goods. Sorbitol and other sugar-
alcohols found in most sugar-free or reduced-sugar
products are poorly absorbed in the gastrointestinal tract
and may cause increased flatulence, abdominal
discomfort, and diarrhea, thus exacerbating IBS
symptoms. Other types of sugar-alcohols proposed to
aggravate IBS symptoms include mannitol, xylitol,
erythritol, lactitol, maltitol, and isomalt.
Increased fiber intake can help to decrease the bloating
in some patients, especially psyllium fiber in patients with
IBS-C. Wheat bran fiber on the other hand has been
shown to actually worsen the symptoms of IBS patients.
This could be due to a wheat intolerance, which is one of
the most common triggers for food sensitivity in people
with IBS.
Several studies have been done on the effectiveness of
probiotics on IBS and the primary endpoints of many
studies are reductions in bloating, abdominal pain and
flatulence.
Single herbs that have been studied include peppermint
oil, turmeric extract, and artichoke leaf. Steam distillation
oil extracts from the peppermint plant (Mentha piperita,
Lamiaceae) are among the oldest remedies for treatment
of GI problems. These extracts are believed to improve
IBS symptoms by exerting a spasmolytic effect on the
smooth muscles in the digestive tract. It is suggested to
give 0.1-0.2 mL three times daily for no longer than two
weeks under the guidance of a health care practitioner.
Exercise can help maintain GI function and reduce stress,
which can help relieve some IBS symptoms. Studies of
IBS indicate positive relationships between physical
activity and symptom relief. Physical activity, such as
pedaling a bicycle and yoga, protect against GI symptom
aggravation and alleviates gas in several studies.
In conclusion, complementary therapies have been
proven to reduce symptoms in patients suffering from
IBS. The treatments recommended will vary from patient
to patient but a combination of dietary modifications,
herbal and nutritional supplementation and lifestyle
changes can greatly improve a patient’s quality of life.
Sources:
1 American College of Gastroenterology Task Force on Irritable Bowel
Syndrome, Brandt LJ, Chey WD, et
al. An evidence-based position statement on the management of irritable
bowel syndrome. Am J Gastroenterol 2009;104:S1-S35.
2 Rey E, Talley NJ. Irritable bowel syndrome: novel views on the
epidemiology and potential risk factors. Dig
Liver Dis 2009;41:772-780.
3 Longstreth GF, Bolus R, Naliboff B, et al. Impact of irritable bowel
syndrome on patients’ lives: development and
psychometric documentation of a disease-specific measure for use in
clinical trials. Eur J Gastroenterol Hepatol 2005;17:411-420.
4 Mathew P, Bhatia SJ. Pathogenesis and management of irritable bowel
syndrome. Trop Gastroenterol 2009;30:19-25.
5 Cash BD, Chey WD. Diagnosis of irritable bowel syndrome.
Gastroenterol Clin North Am 2005;34:205-220.
6 Kong SC, Hurlstone DP, Pocock CY, et al. The incidence of self-
prescribed oral complementary and alternative
medicine use by patients with gastrointestinal diseases. J Clin
Gastroenterol 2005;39:138-141.
7 Heizer WD, McGovern S. The role of diet in symptoms of irritable bowel
syndrome in adults: a narrative review. J Am Diet Assoc 2009;109:
1204-1214.
8 Ford AC, Talley NJ, Spiegel BMR, et al. Effect of fibre, antispasmodics,
and peppermint oil in the treatment of
irritable bowel syndrome: systematic review and meta-analysis. BMJ
2008;337:2313.
9 Vinson B. Development of Iberogast: clinical evidence for
multicomponent herbal mixtures. In: Cooper R, Kronenberg F, eds.
Botanical Medicine: From Bench to Bedside. New Rochelle, NY: Mary
Ann Liebert Inc.; 2009:167-189.
10Grigoleit HG, Grigoleit P. Pharmacology and preclinical
pharmacokinetics of peppermint oil. Phytomedicine 2005;12:612-616.
11 Charrois TL, Hrudey J, Gardiner P, Vohra S. Peppermint oil. Pediatr
Rev 2006;27:e49-e51.
12 Lustyk MK, Jarrett ME, Bennett JC, et al. Does a physically active
lifestyle improve symptoms in women with irritable bowel syndrome?
Gastroenterol aNurs 2001;24:129-137.
Benefits of Fish Oils
Fish oils, sometimes known as Omega 3 fatty acids, are
one of those supplements that truly can benefit so many
people and help to treat a variety of health conditions.
Fish oils contain two essential fatty acids – EPA
(eicosapentaenoic acid) and DHA (docosahexaenoic
acid). These essential fatty acids can be found in
vegetarian sources as well, such as flax oil, however only
a very small amount can be converted into EPA.
So what exactly are these essential fatty acids and how
can they help you? DHA is required for optimal brain
health. The cells that surround the brain need these
fats. Therefore DHA specifically helps with memory
retention, concentration and focus. In addition, it is
required for the brain of a developing baby, so all
pregnant women out there, consider adding fish oils to
your list of supplements. EPA has an anti-inflammatory
affect on the body, so any type of inflammatory condition
such as arthritis, eczema, allergies, inflammatory bowel
disease, asthma and headaches can improve when
these fats are taken. EPA also has a huge impact on
cardiovascular health. Specifically, it can the lower the
“bad” cholesterol and can help with arteriosclerosis.
Eating different types of fish such as mackerel, salmon,
herring, sardines, black cod, anchovies, albacore tuna,
and wild game is a sure way to get your Omega 3 fatty
acids. However, when treating the conditions mentioned
above, sometimes eating fish is not enough. In these
situations a good quality fish oil supplement is often
beneficial.
Premenstrual syndrome (or PMS) is a set of symptoms,
both physical and emotional, that as many as 80% of
women suffer from every month. Most women are able
to manage their symptoms and carry on with daily
routines, however, a small percentage of women (2-5%)
feel it has a significantly negative impact on their lives
where relationships and work are affected. Women who
seek treatment are often prescribed either the birth
control pill (to balance their hormones) and/or anti-
depressant medication (to control their mood).
Naturopathic medicine can provide a wide range of
alternatives to these options with fewer side affects.
Symptoms of PMS vary but the most common ones
include irritability, mood swings, anxiousness, sadness
and fatigue. Physical changes might be bloating, breast
tenderness, headaches and food cravings. Symptoms
usually start a few days before menses but for some
women they could even start right after ovulation, 2
weeks before menses. That’s half a month of feeling
unwell!
Numerous natural alternative therapies are available
including lifestyle changes, vitamin and mineral
supplementation, herbal medicines and natural
hormones. When it comes to treatment, what works for
one person is different than what works for another. We
are all individuals with our own unique physiological and
psychological makeup affected by different stressors.
Treatments offered for my patients vary depending on
their own individual situations but I would like to outline
a few general recommendations.
One of the first steps in treating PMS is addressing liver
function. The liver is responsible for metabolizing
estrogen so if its function is compromised, then this could
lead to excess estrogen levels and an estrogen-
dominant state (one possible underlying cause for PMS).
If the liver is determined to be “sluggish”, then various
nutrients and herbal remedies might be recommended.
Some important dietary suggestions include minimizing
sugar, refined carbohydrates, caffeine, saturated fats
and dairy products. Increase consumption of good fats
(fish, nuts, seeds), legumes, fruits and vegetables.
Studies have shown that specific nutrients are vital in
preventing PMS. These include Vitamin B6, Vitamin E,
Magnesium, Calcium (carbonate) and Gamma Linolenic
Acid (found mostly in Evening Primrose Oil). It’s always
best to get these nutrients from food but if this is not
possible then supplementation is recommended.
Herbal medicines that can be beneficial include Chaste
Tree, St. John’s Wort, Dandelion Leaf, Lemon Balm and
Ginkgo. These herbs can be extremely helpful but it’s
important to speak to a knowledgeable healthcare
practitioner before taking them to ensure the correct
dose and avoid any drug interactions.
PMS is a common condition, with varying degrees of
symptoms but as I’ve outlined here, there are many
treatment options available. PMS can be well addressed
by lifestyle changes and safe and effective nutritional
and herbal supplementation.
Irritable Bowel Syndrome: A Naturopathic
Approach
Irritable bowel syndrome (IBS) is a chronic
gastrointestinal condition that can significantly affect a
person’s quality of life. The disease can be very
frustrating to patients because it often takes a long time
and many laboratory tests to come up the diagnosis, a
diagnosis of exclusion. What that means is that all
laboratory tests come back normal but the symptoms are
there, so all other gastrointestinal disorders are ruled
out and this is the diagnosis that is given as a result.
The purpose of this article is to outline the signs and
symptoms of irritable bowel syndrome, and to discuss
the complementary and alternative treatment options
available.
IBS is defined as “abdominal pain or discomfort that
occurs in association with altered bowel habits over a
period of at least three months.” Symptoms include
constipation and/or diarrhea, flatulence/gas, abdominal
pain/bloating, nausea, anxiety and low appetite. Women
are about 1.5-2 times more likely to develop IBS than
men. Although it is present in all age groups, prevalence
of IBS seems to decline with advanced age. IBS affects
daily functioning, work, mood and lifestyle and interrupts
sleep, which leads to increased fatigue.
IBS symptoms are often compared to inflammatory bowel
disease (Crohn’s disease or ulcerative colitis) or celiac
disease but IBS does not present with any abnormal
laboratory values. Although the pathogenesis of IBS is
not known, a multi-factorial involvement of diet, gene
mutations, psychosocial factors, and immune mediated
processes is hypothesized.
IBS can be classified as diarrhea predominant (IBS-D),
constipation predominant (IBS-C), or a mixed form (IBS-
M). Since the symptoms vary so greatly between
patients, the pharmaceuticals available are mainly
targeted at symptom reduction.
Complimentary or alternative treatments have been
reported to be used in 50% of people suffering from
IBS. A primary goal of all IBS interventions is to provide
the patient with relief of symptoms and improve the
quality of life. Although the data from clinical trials may in
some cases not provide strong evidence for benefits of
dietary modification, it remains the primary non-
pharmacological clinical intervention for IBS patients;
many healthcare practitioners successfully use exclusion
diets.
IBS studies indicate a positive relationship between fat
intake and increased stool number and diarrhea. Intake
of carbohydrates can also aggravate IBS symptoms.
Offending carbohydrates include fructose and fructose-
containing products such as soft drinks, cereals, and
packaged/ baked goods. Sorbitol and other sugar-
alcohols found in most sugar-free or reduced-sugar
products are poorly absorbed in the gastrointestinal tract
and may cause increased flatulence, abdominal
discomfort, and diarrhea, thus exacerbating IBS
symptoms. Other types of sugar-alcohols proposed to
aggravate IBS symptoms include mannitol, xylitol,
erythritol, lactitol, maltitol, and isomalt.
Increased fiber intake can help to decrease the bloating
in some patients, especially psyllium fiber in patients with
IBS-C. Wheat bran fiber on the other hand has been
shown to actually worsen the symptoms of IBS patients.
This could be due to a wheat intolerance, which is one of
the most common triggers for food sensitivity in people
with IBS.
Several studies have been done on the effectiveness of
probiotics on IBS and the primary endpoints of many
studies are reductions in bloating, abdominal pain and
flatulence.
Single herbs that have been studied include peppermint
oil, turmeric extract, and artichoke leaf. Steam distillation
oil extracts from the peppermint plant (Mentha piperita,
Lamiaceae) are among the oldest remedies for treatment
of GI problems. These extracts are believed to improve
IBS symptoms by exerting a spasmolytic effect on the
smooth muscles in the digestive tract. It is suggested to
give 0.1-0.2 mL three times daily for no longer than two
weeks under the guidance of a health care practitioner.
Exercise can help maintain GI function and reduce stress,
which can help relieve some IBS symptoms. Studies of
IBS indicate positive relationships between physical
activity and symptom relief. Physical activity, such as
pedaling a bicycle and yoga, protect against GI symptom
aggravation and alleviates gas in several studies.
In conclusion, complementary therapies have been
proven to reduce symptoms in patients suffering from
IBS. The treatments recommended will vary from patient
to patient but a combination of dietary modifications,
herbal and nutritional supplementation and lifestyle
changes can greatly improve a patient’s quality of life.
Sources:
1 American College of Gastroenterology Task Force on Irritable Bowel
Syndrome, Brandt LJ, Chey WD, et
al. An evidence-based position statement on the management of irritable
bowel syndrome. Am J Gastroenterol 2009;104:S1-S35.
2 Rey E, Talley NJ. Irritable bowel syndrome: novel views on the
epidemiology and potential risk factors. Dig
Liver Dis 2009;41:772-780.
3 Longstreth GF, Bolus R, Naliboff B, et al. Impact of irritable bowel
syndrome on patients’ lives: development and
psychometric documentation of a disease-specific measure for use in
clinical trials. Eur J Gastroenterol Hepatol 2005;17:411-420.
4 Mathew P, Bhatia SJ. Pathogenesis and management of irritable bowel
syndrome. Trop Gastroenterol 2009;30:19-25.
5 Cash BD, Chey WD. Diagnosis of irritable bowel syndrome.
Gastroenterol Clin North Am 2005;34:205-220.
6 Kong SC, Hurlstone DP, Pocock CY, et al. The incidence of self-
prescribed oral complementary and alternative
medicine use by patients with gastrointestinal diseases. J Clin
Gastroenterol 2005;39:138-141.
7 Heizer WD, McGovern S. The role of diet in symptoms of irritable bowel
syndrome in adults: a narrative review. J Am Diet Assoc 2009;109:
1204-1214.
8 Ford AC, Talley NJ, Spiegel BMR, et al. Effect of fibre, antispasmodics,
and peppermint oil in the treatment of
irritable bowel syndrome: systematic review and meta-analysis. BMJ
2008;337:2313.
9 Vinson B. Development of Iberogast: clinical evidence for
multicomponent herbal mixtures. In: Cooper R, Kronenberg F, eds.
Botanical Medicine: From Bench to Bedside. New Rochelle, NY: Mary
Ann Liebert Inc.; 2009:167-189.
10Grigoleit HG, Grigoleit P. Pharmacology and preclinical
pharmacokinetics of peppermint oil. Phytomedicine 2005;12:612-616.
11 Charrois TL, Hrudey J, Gardiner P, Vohra S. Peppermint oil. Pediatr
Rev 2006;27:e49-e51.
12 Lustyk MK, Jarrett ME, Bennett JC, et al. Does a physically active
lifestyle improve symptoms in women with irritable bowel syndrome?
Gastroenterol aNurs 2001;24:129-137.
Benefits of Fish Oils
Fish oils, sometimes known as Omega 3 fatty acids, are
one of those supplements that truly can benefit so many
people and help to treat a variety of health conditions.
Fish oils contain two essential fatty acids – EPA
(eicosapentaenoic acid) and DHA (docosahexaenoic
acid). These essential fatty acids can be found in
vegetarian sources as well, such as flax oil, however only
a very small amount can be converted into EPA.
So what exactly are these essential fatty acids and how
can they help you? DHA is required for optimal brain
health. The cells that surround the brain need these
fats. Therefore DHA specifically helps with memory
retention, concentration and focus. In addition, it is
required for the brain of a developing baby, so all
pregnant women out there, consider adding fish oils to
your list of supplements. EPA has an anti-inflammatory
affect on the body, so any type of inflammatory condition
such as arthritis, eczema, allergies, inflammatory bowel
disease, asthma and headaches can improve when
these fats are taken. EPA also has a huge impact on
cardiovascular health. Specifically, it can the lower the
“bad” cholesterol and can help with arteriosclerosis.
Eating different types of fish such as mackerel, salmon,
herring, sardines, black cod, anchovies, albacore tuna,
and wild game is a sure way to get your Omega 3 fatty
acids. However, when treating the conditions mentioned
above, sometimes eating fish is not enough. In these
situations a good quality fish oil supplement is often
beneficial.
Useful Links
Resources
Alternative Medicine Digest
http://www.alternativemedicine.com
The Friends of Alternative & Complementary Therapies
http://www.thefacts.org
Herb Research Foundation
http://www.herbs.org
Health
Canadian Health Network
http://www.canadian-health-network.ca
Canadian Women's Health Network
http://www.cwhn.ca
Health Canada
http://www.hc-sc.gc.ca/english/index.html
Associations
British Columbia Naturopathic Association
http://www.bcna.ca
The Canadian Association of Naturopathic Doctors
http://naturopathicassoc.ca
The American Association of Naturopathic Physicians
http://www.naturopathic.org
Alternative Medicine Digest
http://www.alternativemedicine.com
The Friends of Alternative & Complementary Therapies
http://www.thefacts.org
Herb Research Foundation
http://www.herbs.org
Health
Canadian Health Network
http://www.canadian-health-network.ca
Canadian Women's Health Network
http://www.cwhn.ca
Health Canada
http://www.hc-sc.gc.ca/english/index.html
Associations
British Columbia Naturopathic Association
http://www.bcna.ca
The Canadian Association of Naturopathic Doctors
http://naturopathicassoc.ca
The American Association of Naturopathic Physicians
http://www.naturopathic.org
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