Overview

Why are serotonin levels important?
Serotonin is the feel-good chemical in your brain.

Serotonin levels are generally lower during PMS, (which accounts for changes in mood), elevating this feel-good chemical in the brain can decrease feelings of stress.^†

Why take PMS Escape^®†
It's clinically proven for fast, sustained.

• Relief of mood swings, tension & irritability^† 
• Energy boost†
• Reduction of carbohydrate & sugar cravings^†

It features a patented, Sustained Balance™ Blend.

This unique combination of simple and complex carbohydrates has been shown to elevate your serotonin for sustained symptom relief.^†

Directions

Mix entire contents of one packet (50 g) with eight to ten ounces of water. (Best if consumed within five to ten minutes of preparation.)

PMS Escape^®† must be taken on an empty stomach-one hour before or two hours after eating a meal or snack.

Recommended Usage: PMS Escape^† can be taken once in the morning and once between 4:00 and 5:00 in the afternoon. If PMS starts in the afternoon, take first serving in the afternoon and second serving about two hours after the first.

Interactions and Depletions

Technical Data

Description

Developed by a female scientist at the Massachusetts Institute of Technology (MIT), PMS Escape premenstrual symptom relief was proven in clinical trials to relieve the symptoms of premenstrual syndrome (PMS).^{† 1-3} PMS Escape contains a blend of ingredients which help promote an increase in serotonin levels.^† Benefits experienced by PMS sufferers in the clinical studies included improved mood, increased energy levels, reduced stress, tension, anger and sadness, and a reduction in cravings for sweets and carbohydrates.^†1-3

Features of PMS Escape^†:

• Promotes healthy serotonin levels^†
• Relief of PMS symptoms^†
• Clinically tested at MIT
• Patented formula^[ii]
• Fat-free, hormone-free
• Easy to use packets – mix with water

Introduction

Premenstrual syndrome (PMS) is characterized by a group of physical and psychological symptoms that appear 3 to 14 days prior to menstruation, and are relieved by the onset of menses. ⁴ Between 70-90% of American women of childbearing age experience uncomfortable symptoms associated with their menstrual cycle. ⁵ Twenty to 40% of this group (12-25 million women) feels their symptoms are severe enough to be diagnosed as PMS.⁵ Common symptoms of PMS are summarized in Table 1.⁶

An average woman experiences 481 menstrual cycles (age 14-51) in her lifetime.⁷ Women with severe symptoms of PMS report an average of 6.4 days of symptoms per cycle, which can be extrapolated to approximately 8 years of impairment over their reproductive lives.⁵

Table 1. Commonly Reported PMS Symptoms
hormonal acne breast swelling and tenderness feeling tired occasional sleeplessness upset stomach, bloating, occasional constipation, or loose stools appetite changes or food cravings trouble concentrating or remembering tension, irritability, mood swings, or crying spells anxiety

The cause of PMS is not fully understood, but is generally attributed to hormone fluctuations, particularly estrogen, progesterone, and serotonin. Estrogen and progesterone have both been shown to influence serotonin production. Research has also shown that low serotonin levels are associated with many of the symptoms of PMS, including irritability, sadness, and increased craving for carbohydrates.⁸ Therefore, it is theorized that relief of PMS symptoms may be obtained through increasing serotonin levels.

Serotonin and Carbohydrate Intake
Serotonin is a hormone found in the brain, platelets, digestive tract, and pineal gland. It acts as a neurotransmitter, stimulating brain cells and controlling mood, sleep, and emotions.⁹ Intake of carbohydrates has been linked to increased serotonin synthesis. Conversely, caloric restriction was linked to a 70% reduction in serotonin levels (animal model).¹⁰ Research has focused on influencing serotonin levels through dietary intake as a way to alleviate the psychological symptoms of PMS.^1-3

Dr. Judith Wurtman of the Massachusetts Institute of Technology has proposed that relief of the symptoms of PMS may be attained through increased consumption of a specific blend of simple and complex carbohydrates.^† This blend is formulated with carbohydrates selected for their ability to increase the ratio of serum tryptophan to large neutral amino acids, and thus enhance serotonin production.^†3 It has been shown that increasing levels of tryptophan, the immediate precursor to serotonin, compared to other amino acids is associated with an increase in brain tryptophan levels and serotonin production.^3,11,12

Clinical Research
Three separate clinical trials have confirmed that intake of a specific blend of simple and complex carbohydrates is effective at relieving the psychological symptoms of PMS.^†1,2,3 In trial one, a double-blind, crossover study, women with confirmed PMS consumed either the experimental beverage (PMS Escape), or one of two drinks with similar total calorie contents but different carbohydrate or carbohydrate/protein blends. PMS Escape was previously found to raise the tryptophan:neutral amino acid ratio by 29%, which the other two blends studied showed no effect on this ratio.^†2 The women consumed the beverages during the late luteal phase of the menstrual cycle, on a day when they were experiencing significantly increased symptoms. Assessments were taken immediately before, and 30, 90, and 180 minutes after consumption of the drinks. Each woman consumed each of the three drinks once during the three month crossover trial. Each month, the women reported their mood and appetite symptoms on a questionnaire. Results were significant for PMS Escape, including reductions in symptoms of sadness, tension, and anger, as well as cravings for sugar and carbohydrates.^{† 2}

Study two. Women with PMS and a control group of non-PMS sufferers were evaluated two days per month (early follicular phase/last luteal phase) at the Massachusetts Institute of Technology Research Center. Both groups completed standard questionnaires assessing mood and alertness, and then consumed a high carbohydrate, low protein meal. The questionnaires were repeated 2 hours post-meal. The PMS group experienced significant decreases in post-meal feelings of sadness, tension, and anger, and increases in calmness and alertness.^† Results are summarized in Table 2.

Table 2.Post-meal Changes in Mood and Energy
41% decrease in tension† 66% reduction in irritability† 43% reduction in sadness† 40% increase in energy†

Study three. Women with PMS were randomized to receive either a carbohydrate-rich beverage (PMS Escape) or a placebo for the 5 days preceding expected menses. Mood and food cravings were assessed at baseline, and again on each treatment day, using standard assessment tools (Daily Symptom Ratings, Profile of Mood States, and Visual Analog Scale). Results found that 73% of women in the PMS Escape groups reported decreased feelings of tension and stress (anxiety) on the day before menstruation.^{† 1}

How Does It Work?

An increase in serotonin levels has been shown to relieve the symptoms of premenstrual syndrome. PMS Escape contains a blend of ingredients shown to increase the tryptophan (immediate precursor to serotonin) to neutral amino acid ratio.^† This, in turn, can lead to an increased level of brain serotonin. The following chart summarizes the benefits of each of the ingredients in PMS Escape.^†

Ingredient	Benefit
Vitamin C	Vitamin C is a potent antioxidant specifically linked to healthy immune and heart function.† 13 Nerve endings in the brain contain the second highest concentration of vitamin C in the human body.14
Vitamin B6	Helps increase production of tryptophan and serotonin in the brain.†15 Relieves the emotional symptoms (tension and irritability) of premenstrual syndrome.†16
Calcium	Supplementation with calcium has been shown to alleviate many of the changes in mood associated with premenstrual syndrome.† 17,18
Magnesium	Low magnesium levels have been reported in women with PMS; magnesium supplementation relieves mood-related symptoms.† 19
Sustained Balance™ Blend	This combination of simple and complex carbohydrates has been shown in clinical trials to reduce psychological symptoms of PMS.†1,2,3

Conclusion
The clinically tested and patented blend of simple and complex carbohydrates in PMS Escape has been shown to significantly reduce the symptoms of PMS.^† This beneficial effect is believed to be due to an increase in the tryptophan to neutral amino acid ratio, which may then lead to a resulting increase in brain serotonin levels.^†

Recommendations

PMS Escape^®† can be taken once in the morning and once between 4:00 and 5:00 in the afternoon. If PMS starts in the afternoon, take first serving in the afternoon and second serving about two hours after the first.

Precautions

If pregnant, nursing, or taking prescription drugs, consult your healthcare practitioner prior to use.

How Is It Supplied?

• 07156; 6 packets

Storage Recommendations

Store at controlled room temperature, 59° to 86°F (15° – 30°C).

References

1. Freeman EW, Stout AL, Endicott J, Spiers P. Treatment of premenstrual syndrome with a carbohydrate rich beverage. Int J Obstet Gyn. 2002;77-253-254.
2. Sayegh R, Schiff I, Wurtman J, Spiers P, McDermott J, Wurtman R. The effect of a carbohydrate-rich beverage on mood appetite and cognitive function in women with premenstrual syndrome. Obstet Gynecol. 1995;86:520-8.
3. Wurtman J, Brzezinski A, Wurtman R, LaFerrere B. Effect of nutrient intake on premenstrual depression. Am J Obstet Gyn. 1999;161:1228-1234.
^[ii] Wurtman JJ. Therapeutic carbohydrate blends useful for aiding premenstrual syndrome. United States Patent 5,760,014. June 2, 1998.
4. Mehring PM. Alterations in structure and function of the female reproductive system. In: Porth CM, ed. Pathophysiology: Concepts of Altered Health States. 5th ed. Philadelphia: Lippincott; 1998:1207-1209.
5. Mishell DR Jr. Premenstrual disorders: epidemiology and disease burden. Am J Manag Care. 2005;11(16 Suppl):S473-9.
6. Premenstrual Syndrome. United States Department of Health and Human Services. Available at: http://www.4women.gov/FAQ/pms.htm. Accessed on September 28, 2007.
7. Halbreich U, Borenstein J, Pearlstein T, Kahn LS. The prevalence, impairment, impact, and burden of premenstrual dysphoric disorder (PMS/PMDD). Psychoneuroendocrinology. 2003 Aug;28 Suppl 3:1-23.
8. Steiner M. Premenstrual syndrome and premenstrual dysphoric disorder: guidelines for management. J Psychiatry Neurosci. 2000 Nov;25(5):459-68.
9. Murray MT, Pizzorno JE. 5-hydroxytryptophan. In: Textbook of Natural Medicine. 2nd ed. Edinburgh: Churchill Livingstone; 1993:783-796.
10. Chandler-Laney PC, Castaneda E, Pritchett CE, et al. A history of caloric restriction induces neurochemical and behavioral changes in rats consistent with models of depression. Pharmacol Biochem Behav. 2007 May;87(1):104-14.
11. Wurtman RJ, Wurtman JJ, Regan MM, et al. Effects of normal meals rich in carbohydrates or proteins on plasma tryptophan and tyrosine ratios. Am J Clin Nutr. 2003 Jan;77(1):128-32.
12. Lyons PM, Truswell AS. Serotonin precursor influenced by type of carbohydrate meal in healthy adults. Am J Clin Nutr. 1988 Mar;47(3):433-9.
13. Bendich A, Langseth L. The health effects of vitamin C supplementation: a review. J Am Coll Nutr. 1995;14(2):124-36.
14. Bourre JM. Effects of nutrients (in food) on the structure and function of the nervous system: update on dietary requirements for brain. Part 1: micronutrients. J Nutr Health Aging. 2006 Sep-Oct;10(5):377-85. Review.
15. Calderón-Guzmán D, Hernández-Islas JL, Espitia-Vázquez I, et al. Pyridoxine, regardless of serotonin levels, increases production of 5-hydroxytryptophan in rat brain. Arch Med Res. 2004;35(4):271-4.
16. Doll H, Brown S, Thurston A, Vessey M. Pyridoxine (vitamin B6) and the premenstrual syndrome: a randomized crossover trial. J R Coll Gen Pract. 1989 Sep;39(326):364-8.
17. Thys-Jacobs S. Micronutrients and the premenstrual syndrome: the case for calcium. J Am Coll Nutr. 2000 Apr;19(2):220-7.
18. Ward MW, Holimon TD. Calcium treatment for premenstrual syndrome. Ann Pharmacother. 1999;33(12):1356-8.
19. Facchinetti F, Borella P, Sances G, Fioroni L, Nappi RE, Genazzani AR. Oral magnesium successfully relieves premenstrual mood changes. Obstet Gynecol. 1991;78(2):177-81.

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