The 'H' in PMS-H stands for "Heaviness, Hydration, Headaches". This subgroup of PMS is characterized by weight gain (greater than three pounds), abdominal bloating and discomfort, breast congestion and mastalgia, and the occasional swelling of the face, hands and ankles. These symptoms are due to an increased extracellular fluid volume which is in turn due to an excess of aldosterone which causes increased fluid retention.
Aldosterone excess during the luteal phase of PMS-H patients may arise due to any of the following factors:
A deficiency in magnesium causes hyperplasia of the adrenal cortex, elevated aldosterone levels, and increased extracellular fluid volume. Aldosterone increases the urinary excretion of magnesium; hence, a positive feedback mechanism results, which is aggravated since there is no renal mechanism for conserving magnesium.
In laboratory animals, a pyridoxine deficiency at the renal level decreases the kidneys' ability to secrete sodium. In addition, since pyridoxine requires magnesium for phosphorylation to its active form, a magnesium deficiency can lead to decreased B6 activity. Increased insulin secretion, in response to sugar consumption, results in sodium retention that is independent of aldosterone.
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