Saturday, May 30, 2009

Magnesium

I've briefly read DR. Carolyn Dean, MD ND's book at Border's once (took about 20min); it's short and easy-peasy. We apparently deplete out Mag a VARIETY of ways:

--breathing
--moving
--living
--generating ATP those little packets of energy produced by mitochondria in every cell (even sperm)
-- remember the Ca-Mg-ATPase enzymes from bio?
--high cortisol, chronically elevated cortisol (eg, insomnia, stress, physical/mental stress, injections for joints or orally for tx of autoimmune d/o or allergic reactions, etc)
--chronic pain syndromes (see above)
--autoimmune diseases (Grave's, Hashimoto's, RA, psoriasis, T1DM, etc)
--high elevated blood glucoses (due to high urination)
--sweating
--exercise (esp endurance types)
--alcohol
--caffeine
--diuretics: HCTZ, furosemide/LASIX, bumetanide, metolazone, chlorthalidone, etc
--diarrhea
--growth (pregnancy, lactation, weight gain, etc)
--acute syndromes (preeclampsia, V-tach, DKA, acidosis, etc)
--high phytic acid and high whole grain intake (binds iron, minerals including Magnesium)
--consumption of nuts/seeds/fruits/veggies grown on depleted soils
--consumption of livestock and fowl raised on grain/depleted-soils


Also, with high calcium supplementation (eg, pregnant/lactating women, post-menopausal women, osteopenic/-porotic individuals) and/or consumption of highly processed food/beverages that are 'calcium-fortified', the minerals Ca++ and Mg++ compete for the same carriers for uptake from the stomach and intestines which prevents uptake of magnesium. Of course, we require Calcium, approximately 300-500 mg daily however minimal dietary calcium is absorbed if blood levels of vitamin D are low (eg, 25OHD less than 20-30 ng/ml).


When initiate vitamin D therapy is initiated, a baseline Mag level and a repeat 1-2mos out should be checked. Unless someone is supplementing Mag, the blood levels typically drop... and I would assume the more accurate assessment, the RBC Magnesium, does critically decrease as well.

Not good.

Initially with vitamin D therapy, Mag will appear 'high' or normal. This is deceptive. Often PTH is also mildly suboptimal (eg, greater than 20-30 pg/ml) though within 'normal standard range' or clinically elevated (eg, greater than 65 pg/ml) which indicates bone resorption and breakdown. The serum Mag is being 'sourced' from degradation of the bone matrix until minerals/hormones are re-balanced.


Many conditions are highly associated with low serum Magnesium:
--atrial fibrillation
--irregular heart beats (PVCs, PACs)
--osteoporosis
--muscle spasms/cramping/Charley horses
--impaired insulin secretion, insulin resistance
--chronic pain, fibromyalgia, back pain, body aches
--headaches, migraines
--hypothyroidism
--hyperthyroidism
--hypertension
--low HDL, high Triglycerides
--high blood glucoses
--dysmenorrhea, PMS, peri-menopausal symptoms
--impaired clotting
--rapid-cycling bipolar


Magnesium (like thyroid hormone) is required by every cell and tissue for every second of our lives to produce ATP and the function of a variety of other vital celllular processes (according to Dr. Dean ~375 but I bet there are more than this now). Maintaining the high end of 'normal' serum levels for Magnesium (2.2-2.5 mg/dl) is extremely prudent if you lack access to RBC Mag measurements. Go by symptoms too -- take enough to eliminate muscle cramps/Charley horses, migraines/headaches, and other overt signs, etc.


Taking warm baths with Epsom salts helps Magnesium status and is very soothing prior to bedtime. (thank you Ted H. for the link)
Bathing in a magnesium-rich Dead Sea salt solution improves skin barrier function, enhances skin hydration, and reduces inflammation in atopic dry skin. Proksch E, et al. Int J Dermatol. 2005 Feb;44(2):151-7.


What form to take?

(a) FOOD -- whole, organic, from farmers and ranchers who rotate crops, compost, pasture-raise livestock/chickens, etc

(b) Safe well water (why your tap water sucks)

(c) Mineral water (variety of brands)

(d) Supplementation:
--Magnesium Aspartate (ZMA w/Zinc used by body builders and X-fitters)
--Chelated Magnesium (Citrate, Amino Acid, etc)
--Magnesium Glycinate ($$$$)
--Magnesium Malate (preferred by many cardiac patients, esp GI-intolerant)
--Magnesium Taurate (Cardiovascular Research brand is raved about)
--Magnesium Orotate (very popular too)
--Magnesium Citrate (CALM makes a liquid kids like)
--Magnesium Ascorbate
--Magnesium Gluconate (weak potency)
--et cetera




Magnesium oxide is the least favorite of members for its poor GI tolerability (more laxative effects, think Mg...'must go') and poor absorption compared with other salt forms.



I started thinking about Magnesium after I came across this provocative article about how potentially statins 'work' to increase HDLs 2-5% initially (not at high dose Zocor/simvastatin and Lipitor/atorvastatin which LOWERS HDLs 2-5% over time by 12 to 24wks) like Magnesium.
Comparison of mechanism and functional effects of magnesium and statin pharmaceuticals. Rosanoff A, Seelig MS. J Am Coll Nutr. 2004 Oct;23(5):501S-505S. Review. PDF here.


Several Magnesium-dependent enzymes exert control on inflammation:
--Mg-ATP complex controls HMG-CoA Reductase, the rate limiting step in cholesterol formation. The authors report "When cellular Mg is low, this ratio tilts towards the active form, and when such a state occurs, more cholesterol, more mevalonate and more of the pathway’s other intermediates will be produced."
--Lecithin cholesterol acyl transferase (LCAT) which lowers LDL and triglyceride levels and raises HDL-cholesterol levels
--Desaturase and other vital enzymes involved in lipid metabolism and balance. "Desaturase catalyzes the first step in the conversion of essential fatty acids (omega-3 and omega-6s) into prostaglandins, which, like the prenylated proteins, have a cascade of stimulating and inhibiting cellular effects important in cardiovascular and overall health."

4 comments:

TedHutchinson said...

Statins and vitamin d
comments on this paper

Increased Levels of 25 Hydroxyvitamin D and 1,25-Dihydroxyvitamin D After Rosuvastatin Treatment: A Novel Pleiotropic Effect of Statins?
This is likely to be the way the claimed clinical benefit of statins is achieved and may be the pleiotropic effect of rosuvastatin, decreasing mortality in patients with coronary artery disease.

But they still don't know the mechanism involved
.

This is a new listing on PUBMED and it's relevant here because It seems that statin may also work their magic by mimicking the actions of vitamin D.

However it seems to me pointless taking a statin (with many obvious and dangerous side effects) that achieves it's magic by actually increasing your vitamin D3 status (by some mechanism as yet unidentified) when you can more cheaply and more effectively achieve the same effect (without any side effects) by taking Cholecalciferol Vitamin D3 by itself.

I think there are plenty of good reason to no only check your Vitamin D intake but also to check you are getting sufficient magnesium.
It is sheer madness (or the perverted logic of big Pharma) to make people take a drug that has potential for unpleasant side effects that works by mimicking a safe supplement that is cheap and doesn't produce side effects at the normal amounts most people reading this require.

TedHutchinson said...

Statins and vitamin d
commenting on this paper

Increased Levels of 25 Hydroxyvitamin D and 1,25-Dihydroxyvitamin D After Rosuvastatin Treatment: A Novel Pleiotropic Effect of Statins? Full text online.
This is likely to be the way the claimed clinical benefit of statins is achieved and may be the pleiotropic effect of rosuvastatin, decreasing mortality in patients with coronary artery disease.

But they still don't know the mechanism involved
.

This is a new listing on PUBMED

It seems to me pointless taking a statin (with many obvious and dangerous side effects) that achieves it's magic by actually increasing your vitamin D3 status (by some mechanism as yet unidentified) when you can more cheaply and more effectively achieve the same effect (without any side effects) by taking Cholecalciferol Vitamin D3 by itself.

It is sheer madness (or the perverted logic of big Pharma) to make people take a drug that has potential for unpleasant side effects that works by mimicking a safe supplement that is cheap and doesn't produce side effects at the normal amounts most people reading this require.

Dr. B G said...

Ted,

DOUBLE thanks!!!

-G

Anonymous said...

Cardiovascular Research formulas have always seemed kind of sketchy to me. I called their product assurance and they told me they were not GMP certified. Sometimes I wonder if all the great magnesium taurate results are due to something else :-/. I prefer magnesium taurate from Douglas Labs or AOR just to be safe. I like to see good quality control on all products!